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Full text of "Preventive medicine, including a disquisition on therapeutic philosophy"

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Preventive Medicine 



INCLUDING 



A DISQUISITION ON 



THERAPEUTIC PHILOSOPHY 



By William Colby Cooper, N. D. 



Published by the Author 



CLEVES, O., 1905 



Copyright 1903 by 
WILLIAM COLBY COOPER, M. D. 



W. E. TAYLOR 
Printer and Publisher 

HARRISON, o. 



• •• 

• • • 

> •• • 






PREFACE 



T HAVE no apologies to offer for this 
book. I am not ashamed of either its 
matter or manner. Its purpose is wholly 
righteous, and I believe the time is ripe 
for just such a book. Its heterodoxy will 
be orthodoxy within fifty years . It hits 
each school of medicine about equally 
hard, and accords to each sect all the 
credit and honor due it. I hope it will 
be received in the kindly spirit in which 
it was written. It is dedicated to all 
thinking sanitarians, doctors and edu- 
cators. W. C.C. 

Cleves, 0., Aug. 18, 1905. 



65r>vSt 



PREVENTIVE MEDICINE 



PART FIRST 

PURELY PREVENTIVE 

THE WORD medicine will be used in 
this work purely in the drug sense. As 
drugs are directly and solely related to 
disease, the phrase Preventive Medicine, 
literally construed, would mean medicine 
to prevent disease. As there is not, and, 
in the nature of things, never will be a 
drug preventive of disease, this interpret- 
ation of the phrase is excluded. What we 
understand by the phrase is that system, 
of observances which will best prevent the 
necessity for the use of drugs. In other 
words, the phrase has reference to the 
best mode of preventing sickness, either 
in the individual, or in the community. 
Very particularly too, it relates to that 
enlightenment which precisively distin- 
guishes between the needful , and the 
needless, use of drugs. 



2 PREVENTIVE MEDICINE 

The subject naturally falls into two 
great divisions : first, Stirpiculture ; and 
second. Sanitation, individual and general. 
In the latter is specially included a 
knowledge of when to give medicine, and 
when not to do so. 

A stock argument in favor of homo- 
culture depends upon the results realized 
by breeders of the lower animals. The 
argument is mainly gratuitous, for all 
civilized people understand that favoring 
conditions in any department of human 
affairs are promotive of our wellbeing. 
After all, though, the argument is justi- 
fied by the moral sting it holds ; for, if an 
individual will, for a mercenary reason, 
improve the physical condition of his 
stock, what should not the social organism 
do for the physical betterment of man- 
kind? A natural mitigant of this re- 
proach inheres in the fact^that the stock 
breeder is an autocrat in relation to his 
stock, while no headj^of a State or com- 
munity has such power over the people 
subject to him. However, the people in 
their corporate estate can do much more 



PREVENTIVE MEDICINE 3 

than they, are doing for the physical, and 
consequently the moral, condition of the 
race. This phase of the question will be 
discussed under the second classification. 
The prime requisite to good health is 
good birth. It is the primitive right of 
every child to be well born ; it is the 
sacred duty of mankind to see to it, as 
far as may be, that children are well 
born. It is a fashion for Love to "laugh 
at lock-smiths" and the biological eligi- 
bilities for marriage, and it is held to be 
impossible to make laws which will 
wholly control all classes in this matter. 
The ultimate possibility of such laws will 
depend upon the education of the public 
conscience, and it is easily conceivable 
that this can be done to a sufficient de- 
gree within half a century. This edu- 
cative process will be considered later. 
Really, before the school boy of today is a 
grandfather, the enactment of restrictive 
marriage laws should be practicable. 
Surely the time is not so far distant 
when popular sentiment will justify a 
law requiring a certificate of physical 



4 PREVENTIVE MEDICINE 

fitness from each of the contracting 
parties before their marriage will be per- 
mitted. Under this ideal state of affairs,, 
there would exist in every county a board 
of medical examiners whose duty it would 
be to examine all matrimonial candi- 
dates, male and female. Those found to- 
be possessed of a transmissible taint, such 
as that of syphilis, scrofula, tuberculosis, 
etc., would be refused a certificate, while 
those found to be sound would be granted 
it. There are uncounted thousands of 
people who are sufficiently civilized to 
vote for such an arrangement right now. 
There are a few ultra-modern doctors 
whose ultra-modern theories require the 
abolition of heredity, in its relation to 
phthisis pulmonalis. But everybody, 
including these ultra-moderns, knows that 
heredity is the very bole of being. With- 
out it, there is nothing. Human proro- 
gation is only a refined mode of fission, 
and the baby hydrozoon is not more 
like its parent than is the baby human 
like its forebears. Each of us is "an 
omnibus, loaded full of our ancestors." 



PREVENTIVE MEDICINE 5 

We are derived from our immediate, 
and foreparents, and there is nothing 
in us which was not transmitted to us 
from them. Like causes produce like 
effects, and there is no scientific reason 
why we are related to this law in an ex- 
ceptional sense. There is no scientific 
reason why a diathesis is less transmissi- 
ble than is the complexion, seeing that 
although it may be said to be adventi- 
tious, it is no less a part of the progenitor 
than is his, or her complexion. The dis- 
sipation of a morbid physical habit can 
depend on nothing less than judicious 
crossing, and we know that this will ulti- 
mately run it out. Note, that this possi- 
bility is that upon which eugenics de- 
pends, and that it all results from the 
master fact of heredity. The achieve- 
ments of the stock breeder depend wholly 
and solely upon the fact of heredity, and 
who shall deny that these achievements 
are actual and real? We must all admit 
then, nolens voUns, that homoculture is a 
great organic fact, and that the eradica- 
tion of vicious physical and moral taints 



Q PREVENTIVE MEDICINE 

must depend upon its intelligent applica- 
tion to the social fabric. While the edu- 
cation of public sentiment will do some- 
thing toward securing- more discriminate 
marriages, it is not one-tenth sufficient, 
unless concentratedly and mandatorily 
expressed. In other words, to be effec- 
tive, it must express itself in statutory 
law. It may be long before such laws, 
can be enacted and enforced, but until 
this can be done, the highest social ideal 
must remain unrealized.- 

Directly associated with this part of 
the subject, is criminology. Disease 
means crime', crime means disease. The 
restrictive laws suggested would not reach 
the very lowest closes, for the reason 
that they would perpetuate their kind 
without reference to m arriage . Thieves , 
murderers, etc., are none too good to com- 
mit fornication. This is not to say that 
only the worst crimnals are ever guilty of 
that crime, but this feature of the question 
belongs more strictly to the domain of 
morals. The roue is despicable, but he is 
oot usually the propagator and spreader 



PREVENTIVE MEDICINE 7 

of disease, nor, for that matter, of thievery 
and murder. Now there is but one way 
of abating an effect, and that consists in 
abating its cause. In sociology some 
very fine ethical discriminations become 
necessary in reference to the right as be- 
tween the mass and individual. The ex- 
periences of the past have settled this 
much : that the tenure of individual priv- 
ilege is justly derived from collective con- 
sent. It is just, therefore, that the State 
should have the power of depriving the 
criminal of the possibility of committing 
deeds which are inimical to public well- 
being. The law seeks to prevent evil 
social effects, as far as may be, by sup- 
pressing their causes. Thus, it deprives 
criminals of their liberty, and in extreme 
cases, of their lives. The righteousness 
of this power, and of its assertion, must 
stand unquestioned. If every natural, 
and irrepressible criminal could be im- 
prisoned for life, in a few generations the 
diseases and immoralities peculiar to this 
class, would be almost entirely wiped out. 
The disease-taint, criminality, ^w\VL *X 



8 PREVENTIVE MEDICINE 

least be reduced to a minimum. Of 
course, reference is had here to only that 
form of crime which is comprehended in 
robbery, murder, etc., for it would not be 
practicable to imprison for life all who 
are merely dishonest, lecherous, etc., for 
that would be to reduce our population 
two-thirds at least — God pity us ! 

It seems that there are many, and per- 
haps good, reasons why we cannot im- 
prison the recidivist for life. What shall 
we do with these incorrigible? Out of 
our deepest sense of justice, leaps the 
ready answer— -coAtrate them. Stop them 
from multiplying, and perpetuating their 
kind. This is a means, and the only 
morally permissible means of ridding the 
earth of these human beasts of prey. If 
a man has a right to kill another in self- 
defense, the people, in their corporate 
capacity, have the right to unsex the 
human rodent who is undermining the 
social structure. Crime, and especially 
in its more atrocious forms, is a disease, 
and it is a disease whose eradication re- 
quires heroic treatment. This is the 



PREVENTIVE MEDICINE Q 

only sure remedy that is practicable. 
This means would have the merit of be- 
ing preventive in a double sense; first, 
in the true sense that all cure is preventive, 
since to cure a disease is to stop it, i. e., 
to prevent its further progress ; and second, 
in the sense that it would prevent the re- 
production of new, and independent, pro- 
moters of the disease. This question of 
emasculation as a remedy against future 
outlawry* . lias been timidly discussed 
through the medical press. The question 
should be aired boldly, insistently, and 
persistently .through, the lay, not less 
than through the medical press. We owe 
it to humanity to hammer away at this 
vital question until public opinion shall 
force pur law-makers to erect it into a 
statute. In a more purely moral and 
legal light, this is to be remembered, too : 
all the other penal laws together have 
not half the deterrent force which would 
abide in a castration law. The enact- 
ment of such a law would constitute a 
long stride in practical eugenics, and we 
know that upon the physical improve- 



10 PREVENTIVE MEDICINE 

ment of the race depends health and good 
morals, more than upon all things else 
combined. Stirpiculture, therefore, rep- 
resents the largest factor in Preventive 
Medicine. 

I am aware that there are many to 
whom emasculation would seem brutal — 
even barbarous. But think of it — if the 
operation is often justified by a patholog- 
ical condition for une (perhaps unworthy) 
individual's sake, is it not justified by 
social pathology, especially when scores 
will be benefitted thereby? If there must 
be sentiment in the case (and there must 
be), put the welVbeing of society against 
the illbeing of a. few criminals and outlaws. 
In exactly the reverse of a merciless spir- 
it, I say that things happen in vicious 
circles that make the whipping post a 
gracious memory. We must be merciful, 
but is there any ethical reason why we 
should be more merciful to the undeserv- 
ing than to the deserving? 

Ranking next in importance, referen- 
tially to the prevention of disease, is 
Sanitation. For the sake of convenience, 



PREVENTIVE MEDICINE 1 1 

the word* sanitation is used here in a sub- 
servient sense, though in' if act, it is the 
dominant term, since it includes stirpi- 
culture. 

The physician being the natural con- 
servator of physical soundness, all ques- 
tions pertaining to health, and disease, 
are necessarily turned over to him.' Be- 
fore the doctor can do much effective 
work along this line, there must be a 
reform in medical ethics. The objection 
to public-print exploitation (creditable in 
its original essence), must be sunk in 
philanthropy. Doctors must speak di- 
rectly to the people through the news- 
papers and the magazines. Discussions 
of public-health questions in the medical 
journals, are generally more entertaining 
than instructive to the competent physi- 
cian. They do the layman almost no 
good. The public-spirited layman is the 
one we want to reach. That form of con- 
tempt which is the inevitable outcome of 
familiarity— compatible as it is with the 
warmest friendship— will always take 
much of the force out of the family doc- 



12 PREVENTIVE MEDICINE 

tor's generalizations. Whether we will, or 
not, a sense of cheapness goes with our 
face-to-face publicism, and it falls far short 
in that impressiveness which works con- 
viction, find stirs to action. "A prophet 
is not without honor/' etc.; also, "Dis- 
tance lends enchantment, etc." I have 
squirmed under the assertiveness of this 
principle in human nature many a time, 
and so have you, dear doctor. It must al- 
ways be taken into account in our social 
reckonings. But really, no argument is 
required here ; we know that the secular 
press is the mplder of public opinion, and 
that popular sentiment is the instigator 
and backer of our laws. 

Would writing articles (or the lay press 
on the subject of private and public 
sanitation, compromise medical dignity? 
Certainly not, if the writing be done by a 
layman. Is the nature of medical dig- 
nity such that its intact maintenance de- 
pends upon the physician 's abstinence 
from public good deeds, these deeds hav- 
ing a medical relationship? I think not. 
If the king shake hands with a coal- 



PREVENTIVES MEDICINE 13 

heaver, whatever effect it may have 
upon his royal dignity, it will not damage 
his true dignity. It seems that true dig- 
nity is less fragile than the ultra-polite 
have supposed ; that, indeed, it is compat- 
ible with any form of goodness. It is my 
opinion that the representative physician 
of this glowing age is too large a man to 
be enthralled by the ethical stiffness of 
the past. His code of ethics is the Golden 
Rule, and his standard of dignity is not 
hedged by written formulae. 

INFANCY 

If a child be well born, at least two- 
thirds of its battle for life is won. Per- 
haps one out of one hundred is so born, 
and whether it is so born or not, is purely a 
question of accident. In these cases, it sim- 
ply happened that the right man and right 
woman attracted each other unto marri- 
age. The match was evolved out of a 
fortuitous concourse of social influences. 
Under conditions which are doubtlessly 
possible, at least half the children might 
be well born. Even the fortuitous com- 



14 PREVENTIVE MEDICINE 

binations alluded to would become fewer > 
for it is the function of system to elimin- 
ate chance. The law would prevent the 
fruition of unfortunate interpersonal at- 
tractions. The care of the infant must 
be left to the instincts of motherhood, 
supplemented by the oversight of the 
family physician, as the matter now 
stands. 

It should be popularly taught that the 
first, and most critical period of life is 
from the time of birth, up to the age of 
seven. School misses should absorb this 
fact from their school readers, and teach- 
ers should tamp it into them. If this 
were done, and if, in connection with 
this, it were taught why it is a critical 
period, and if, in connection with this, it 
were taught how to prevent disease, these 
misses would become fitted for becoming 
capable mothers in one important respect 
at least. Physiology, as taught in our 
common schools, does not do this ; indeed 
it falls far short of it. The most it teaches 
is ornamental knowledge, not practical 
facts. Scholastic physiology, so to call it, 



PREVENTIVE MEDICINE 15 

is of little real benefit to the miss in rela- 
tion to her possible future motherhood. 
A woman may become a tolerably suc- 
cessful mother without being well up in 
histogenesis, for instance ; but she can- 
not succeed well if she does not possess a 
working knowledge of practical hygiene. 
A small, plainly, and simply written book 
upon the care of children from birth up 
to the age of seven or eight, is a desidera- 
tum. It should be for the use of girls 
from the age of twelve to sixteen. Of 
course, it should contain no reference to 
the process of birth, nor anything else 
that could shock the modesty, or spoil 
the innocence of young girlhood. The 
most elementary physiology the writer 
has seen is all right in this respect, but 
misses it in being too technically proper — 
too academic. To realize the over-riding 
importance of the care of young children, 
we need only to recollect that seventy-five 
per cent, of all fatalities under the age of 
five, are preventable. 



16 PREVENTIVE MEDICINE 

VACCINATION 

According to my experience, it is not 
good to vaccinate a child before it is a 
year old. A child may be vaccinated 
earlier if smallpox is prevailing, but vac- 
cinia is frequently a severe disease, and 
it does not seem wise to subject an in- 
fant's small stock of vitality to this draft, 
if the operation can be postponed. I am 
a moderate believer in the efficacy of 
vaccination, but with me, as with every- 
body else, it is a matter of belief only. I 
do not know it is protective. That the 
question is a debatable one, we are forced 
to admit, for it is being vigorously debated 
all over the country. If we would be fair 
and unpartisan, we must also admit that 
antivaccinationists are as good and as in- 
telligent as we are ; and that their right 
to differ from us, is the precise measure 
of our right to differ from them. They 
are not a set of paranoiacs — they are our 
peers . Their articles in opposition to vac- 
cination are as learned as ours in favor of 
it, and their statistics are scarcely less 
ample than ours. The nature of the 



PREVENTIVE MEDICINE 17 

question is such, that it is the sacred 
right of all parents to vaccinate their 
children, or not, just as they please. 
Whether vaccination is protective, or not, 
the non-vaccinated can be no menace to the 
vaccinated. As the question is one of 
belief, and not one of positive knowledge, 
to enforce vaccination by law, is to vio- 
late the spirit and traditions of this re- 
public ; indeed, it is to violate the organic 
law of this nation. The broad-gauge 
medical man cannot afford to stoop to the 
sanction of any form of Procrustianism. 
The recent exploit of Dr. Friedrick, health 
officer of Cleveland, has the appearance 
of a knock-out argument against the 
efficacy of vaccination. A saturnalia of 
vaccination had been going on in Cleve- 
land. Very many had nearly lost their 
arms, and at last four died of tetanus as 
a direct result of vaccination. Still small- 
pox raged . At last Dr . Friedrick " took the 
bit in his teeth' ' and ordered all the vac- 
cinating stopped. With the co-operation 
of the Mayor, he instituted a house-to- 
house disinfection. The disinfectant 



18 PREVENTIVE MEDICINE 

used was formaldehyde. In the begin- 
ning of his report, he says : "It affords 
me great pleasure to state that the house- 
to-house disinfection freed Cleveland of 
smallpox," etc., etc. He closes his re- 
port thus : "Cleveland is now free from 
smallpox, and from the worst infected of 
all cities, it has become the cleanest." 
The breed of smallpox germs they had at 
Cleveland, laughed at vaccination, but 
promptly died under formaldehyde. 

I know from personal experience how 
rooted is the usual physician's faith in 
vaccination. I know too how rudely the 
foregoing remarks will jar the sensibili- 
ties of many a brother, but my trust in 
the strong common sense, the spirit of 
fairness, and the increasing tolerance of 
the up-to-date physician, seemed to fur- 
nish enough of justification for my re- 
marks. It is my firm conviction that 
proper vaccination gives at least partial 
immunity from smallpox. I am far from 
sure that the renunciation of the old- 
fashioned method, and the commerciali- 
zation of the virus business, has been a 
good thing. 



PREVENTIVE MEDICINE 1Q 

THE KINDERGARTEN 

The kindergarten idea is all right. The 
virilization of the play spirit for the sake 
of education, is both physiologically and 
psychologically justified. Extreme youth 
is nine-tenths the vegetative period of 
life. With the lower animals, without 
reference to their age-limits, days corre- 
spond to months or several months for 
the human being in relation to develop- 
ment. The mighty significance of this 
gulf, was brought out for the first time 
by that distinguished scholar and philoso- 
pher, John Fiske. It constitutes almost 
the only humanizing factor in the scheme 
of evolution. This is not the place lor 
expansion upon that subject, but its study 
is respectfully recommended to the pro- 
fession. 

This vegetative process, above alluded 
to, must not be interfered with. No effort 
should be made to teach a child much of 
anything intellectual before it is five or 
six years old ; it gets enough of mental 
exercise in learning the rudiments of a 
language. It may be put into the kinder- 



20 PREVENTIVE MEDICINE 

garten at almost any time after it is two 
years old, but while there, its whole time 
should be occupied in playing. It nok 
only must not know that while it is play- 
ing, it is working, but in fact no part of 
its play must be work. The work feature 
must be purely incidental. The play in- 
stinct is wholly conservatory and has ref- 
erence, four-fifths to bodily development^ 
and one-fifth to social growth. This 
social growth includes specially that riant 
quality which is essentially the basis of 
optimism, without which there could be- 
no social structure. 

Now the tendency of all specialisms is 
toward auxesis, particularly incident to- 
which is a swelling specific ambition, and 
a straight-laced mode of thought. Under- 
stand, this is the tendency, and a state- 
ment of the fact is not to return an indict- 
ment against specialism, for, happily, an 
overwhelming majority of our specialists 
are constitutionally too large to be spoiled 
by any influence. It is scarcely an exag- 
geration to say that specialism is the hope 
of the world. The objections that have 



PREVENTIVE MEDICINE 21 

been brought against the kindergarten 
by physicians and other humanitarians, 
is that it seems next to impossible to pre- 
vent the abuse of its underlying idea. 
This results from the auxetic aura special 
to specialism, as above referred to. In 
many kindergarten overseers (teachers?) 
the preceptorial impulse gradually works 
itself into assertiveness, and little tasks 
are imposed upon the tots. The spirit of 
emulation is awakened and ambitions 
started and fostered, all of which are sub- 
versive of the original purpose of the 
kindergarten, for it means mental fatigue 
-and nervous irritation. In such cases, 
the child is being irreparably wronged, 
for it is being made supersusceptible to 
abnormal invasions at least. The babies 
must only play, and if they can absorb 
some useful knowledge from this play 
without subtracting any zest from it, all 
the better. When allkindergarten teach- 
ers shall square their efforts to this fact, 
then the institution will become an un- 
mixed blessing. This is the rule that 



22 PREVENTIVE MEDICINE 

must govern the overseer in regard to her 
little charges : 

Play, they must; learn, they may; 
Learn or not, they still must play. 

SCHOOL LIFE 

This should be the happiest, and most 
health-giving period of life. It is such to 
the child who has a bookish bent, and 
who is phenomenally brilliant. Such a 
child, besides the school-mate benefits 
common to them all, derives positive 
pleasure from the prosecution of its. 
studies. The school life of such a child is> 
a succession of intellectual triumphs, un- 
manned by the humiliations of failures , 
the pain of reproofs, and all the other 
bitternesses and degradations that are 
heaped upon the dull pupil. 

With reference to school life, the differ- 
ences in disposition, temperament, and 
very particularly mental endowment in 
children, furnish the elements of about 
the most difficult jiroblem socially known. 
Our schools are run on a basis which pre- 
supposes a perfect equality as to nature, 



PREVENTIVE MEDICINE 23 

perspicacity, and aptitude, among all 
children. This, of course, is cruelly, even 
atrociously wrong. Dr. I. N. Love, in 
his fine essay on "Children's Rights," 
says: "No one would think of placing 
fifty or a hundred children, either of 
small or larger growth, at a table with a 
uniform bill of fare, commanding them 
all to eat the same amount of food, good, 
bad, and indifferent, without looking for 
numerous cases of indigestion and even 
fatalities to follow, but in the schools this 
thing is done every day. The child's ca- 
pacity for digesting this subject or that 
branch of knowledge, is not considered/ 1 
Each child is an insular output of evo- 
lution, bounded by his capacities. He 
cannot transcend himself ; he should not 
be forced below himself. It is right that 
he should revolve in his own orbit, since 
he cannot be fitted to any other one. 
This fact furnishes the basis of the ideal 
school-method, which would be to have 
about as many grades as there are pupils. 
To the extent that we vary from this, we 
wrong the child physically, morally and 



24 PREVENTIVE MEDICINE 

mentally. In what glowing epoch of the 
throbbing future shall this ideal be re- 
alized? Not until stirpiculture shall have 
been long a universal fact, and the social 
fabric, as a consequence, shall have been 
refined into that estate that will include 
the possibility of every adjustment which 
makes for human perfection. 

We cannot now realize this ideal, but 
we can do the next best thing — we can 
live, and work toward it. We can prune 
away evident abuses, and institute posi- 
tive reforms. Before any great improve- 
ment can be made, there is a fundamen- 
tal proposition to be established. It de- 
pends upon a correct answer to the ques- 
tion : What is true education? Is it rep- 
resented in the classical scholar? Is 
book-learning its dominant feature? On 
the other hand, should instruction have 
main reference to the hard materialities 
of life? Should the severe practicalities 
of living be mostly taught? Would it be 
better to strike a mean between these? 
Of course, true education consists in that 
quality of knowledge which will enable 



PREVENTIVE MEDICINE 25 

its possessor to do the most good, both for 
himself and for others. But that is a 
generalization. Whatever shall be the 
meaning of this basic proposition, it must 
result from a confluence of the best wis- 
dom of professional educators and repre- 
sentative physicians. It is exactly as in- 
disputable as it is unfortunate, that the 
present status of our schools and colleges 
is not a product of the united wisdoms 
referred to. Our college presidents and 
public school superintendents have not 
made partners of the doctors, in the es- 
tablishment of their curricula and their 
school policies. There is not a thoughful 
and experienced physician in the land 
who does not vigorously condemn many 
of the disease-breeding and life-sapping 
features of our present strenuous educa- 
tional system. This point is respectfully 
submitted. 

I am not going to tell our educators 
how to do it, but feel that it will do no 
harm to loose upon them a few playful 
vagaries in regard to school work. Theo- 
retically, there are ways and ways of 



26 PBETKNTTVZ MEDICINE 

at least mitigating school evils. It is 
past question that our schools are too 
crowded. No teacher can do justice to 
more than twenty-five or thirty pupil*— 
this goes without the saying. There are 
at least three humane ways of overcoming 
this evil. One would consist in the prac- 
tilixation of the Malthusian doctrine, but 
that cannot be until eugenics shall have 
become a permanent fixture in our civ- 
ilization. That remedy is necessarily ex- 
cluded for the present. A second remedy 
would depend upon the multiplication of 
our school houses, and school teachers. 
For monetary reasons — whieh are base 
ones in this connection — this plan will 
have to be marked, "infeasible." Re- 
membering that our children are the rip- 
ening red corpuscles of the nation's future 
blood ; remembering that upon the health 
and integrity of these corpuscles will de- 
pend the perpetuation of our civil institu- 
tions; remembering that the happiness 
and moral destiny of all the people of all 
the world hang upon the growth and sta- 
bility of civilized centers, what sacrifice 



PREVENTiVE MEDICINE 27 

should we not make for the children? 
See what an opportunity for doing hn* 
measurable and immort&l good, our mul- 
timillionaires are letting slip by theittl 
It is well enough to endow colleges and 
create libraries, but every gill of philan- 
thropy applied to the roots of education 
will do more good than gallons of it 
poured upon its blossoms. Oh, that a 
bolt of enlightenment might strike them, 
and blessedly inspire them to help our 
children , and so, help the world ! What 
is the cheap, base glory of multimil- 
lionairisra, as compared with the re- 
splendence of a world-circling benefaction 
—of a fact that would bum all their glow- 
ing names into all the waiting aeons of 
the palpitant future? They could com- 
bine and contribute a billion of dollars for 
the betterment of our schools, and still 
remain dangerously and taiser&bly Wealthy. 
It would fit the noble impulses of such a 
man as Mr. Carnegie to inaugurate such 
a movement as has been here suggested. 

There is a third method of doing away 
with the crowding evil, which as I see i%, 



28 PREVENTIVE MEDICINE 

is practicable. This would consist in a re- 
lay, or shift system. The crowded grades 
could be split into halves, and each half 
could attend school on alternate days, or 
half days. The objection that such an ar- 
rangement would reduce the child's educa- 
tional opportunity one-half, is not even 
logically, much more, humanely tenable. 
If there are sixty in the D grade, the 
teacher can give each one only half the spe- 
cific and personal attention which would 
be possible if there were only thirty in the 
grade. The significance of this is easily 
seen when it is remembered how much 
depends upon this person-to-person inter- 
course. The nervous strain, both upon 
the teacher and the pupil, but particular- 
ly upon the former, would be reduced one- 
half. This would greatly benefit both, for 
the child would be more comfortable and 
less distracted from his studies, while the 
teacher's comfort and efficiency would be 
exactly doubled. A prime fact in the 
case is that all of them would be health- 
ier. The alternate holiday, or half-holi- 
day, would increase the child's opportun- 



PREVENTIVE MEDICINE 29 

ity for that natural physical culture which 
his little nervous, and muscular, systems 
so perpetually cry out for. It is my firm 
conviction that under such a system, any 
shortage in the child's grade at the end of 
the year, would be doubly compensated 
by his improved physical vigor. 

All observing physicians agree that the 
curricula of our schools are also too crowd- 
ed. There are too many studies. We see it 
in the squeezed-out and etiolated condition 
of our "sweet girl graduates." The pur- 
pose seems to be to force a quart of learn- 
ing into a pint of brain . Again , our ed- 
ucators accord no differences to the criti- 
cal period of a girl's life. I feel like say- 
ing that it should be a penitentiary of- 
fense to send a girl to school during her 
developemental crisis. Millions of fair 
lives have been wrecked or destroyed by 
the conjunction of the two wrongs above 
cited. Too crowded, too pushed, too 
crammed — this is the deadly trinity that 
is blighting promiseful young lives. Three 
destroying too's, when it is a cardinal 



30 PREVENTIVE MEDICINE 

sanitary, an4 moral, fact that not one too 
ahouU} be related to the young. 

aih HOLES 
The importance of parks is coming to 
he pretty well understood. Their esthetic 
value alone is a good pleader for them. 
The larger cities are pretty sure to have 
their parks, and to make them beautiful 
and attractive. This is well, but how 
about the parklets? There should be 
breathing places in the congested parts of 
all large cities. This fact applies partic- 
ularly to the tenement districts. Modern 
teuementism, owing to the heartlessness 
of human greed, is an urban cancer. 
Thus far, no municipality has been able 
to secure a knife big enough, or caustic 
strong enough to eradicate them. As 
things are, the best thing to be done is to 
mitigate their bad effects as much as pos- 
sible. The establishment of little parks 
throughout these sections would do that. 
They need not be over two hundred 
feet square. They should have grass, 
trees, a fountain, seats, etc. In some 



PREVENTIVE MEDICINE 31 

part of each one there should be a sand 
pile for the children. Here, of an even- 
ing, the tired, smothered denizens of .the 
district could get a sniff of partially fresh 
air, and here their children could have 
the dear privilege of romping, and being 
children. Here they could get some re- 
lief from the crowd-poison whioh breeds 
not only disease, but vice. The large 
parks are inaccessible to the people ex- 
cept on Sundays, and they rarely go then. 
These are patronized more by the better- 
to-do people. These smaller air holes — 
these ventilators are perfectly possible, 
and their urgent need is unquestionable. 
It would cost money, but it would save 
money in the end. In very self-protec- 
tion, if from no nobler reason, every large 
city should establish these parklets in 
their crowded, and especially in their 
tenement districts. Here again, is a want 
that turns appealingly to the philan- 
thropic Croesus. 



32 PREVENTIVE MEDICINE 

MEDICAL LEGISLATION 

Any legistation which is actually pro- 
motive of health, is to the last degree de- 
sirable. Any legislation which derives 
its color from orthodox method in ther- 
apeutics, is to be reprehended, for there 
is no orthodox therapeutics. Only such 
medical legislation as pertains to hy- 
giene is legitimate. Included in this, 
is the enactment of laws that refer to 
private and public sanitation, quaran- 
tine, etc. The legal establishment of 
health boards is right, for the sanitary 
interest must have a head. Because 
the members of health boards are hu- 
man, they are more or less susceptible 
to that place-pride which conduces to 
abuse of power. It is notable that our 
health boards do not always successfully 
restrict themselves with reference to 
common-sense intent. The tendency is 
for them to exceed the purpose of their 
being. They frequently assume an 
authority which is not essential to their 
positions. It is the habit of these boards 
to exaggerate the contagion of disease. 



PREVENTIVE MEDICINE Q$ 

It may be cautiously admitted that con- 
sumption is remotely contagious. So far 
as I know i it remains to be proved that 
anyone ever directly ' 'caught' ' tuberculo- 
sis from another, but according to most 
health boards it is an exceedingly con- 
tagious disease, and the victims of it 
should be segregrated into a special hos- 
pital. Diphtheria and typhoid fever, and 
tonsilitis, and croup, are only possibly con- 
tagious, yet they are quarantined against 
with the severest rigor. To me these acts 
seem to be the outcome of martinetish ex- 
tremism, which can do little but harm. 
It is a form of intemperance, and no kind 
of intemperance ever does good. The 
very doctors who, by these acts, preach 
the intense contagion of almost all 
diseases, know — if they have had any 
practical experience — that disease is 
not one-tenth as contagious as the laity 
usually believe it to be. It is safe to say 
that not one doctor in a thousand ever 
contracts a contagious disease. What is 
there to protect the doctor any more than 
the layman, except his fearlessness, and 



34 PREVENTIVE MEDICINE 

what does this depend on except his 
knowledge of the fact that the contagious- 
ness of disease is enormously overbelieved 
in? What will protect the doctor will 
protect the layman, but these health con- 
servators (?) are robbing the latter of the 
little psychological protection they may 
have had. Such teachings feed and foster 
a nervous solicitude that is contagious — 
highly so — and this condition beckons 
with both hands to every disease that may 
be prowling around. This mental con- 
tagion is absorbed by the children, and 
to that extent their danger from the in- 
fectious, and even the other diseases of 
childhood, is greatly increased. We 
should never forget that psychology has 
just half to do with both the contraction 
of, and the emergence from, any morbid 
condition. Many a health-board enthusi- 
ast is controlled more by the dicta of the 
doddering doctrinaire, than by the con- 
sensus of conclusions flowing from the 
busy, practical mass of practitioners. 
They have fallen into the representative- 
ship of closet-student theories which they 



PREVENTIVE MEDICINE 35 

have construed to be philosophy, and with 
the best of intentions, they practically 
exploit these theories . Bacteriology-gone- 
mad is responsible for this contagio- 
phobia, so to name it. The germ theory 
malady is now (1903) in its acute stage. 
Not till convalescence is entered upon, 
may we hope for voluntary temperance 
along this line on the part of those who 
are vested with medical authority. Re- 
ally, no man should be on a health-board 
who has not been in active practice for 
twenty years. 

The picturesque antics of health-board 
doctors, as seen in quarantining one 
State against another, would be laughable 
if they weren't so astringently unlaugh- 
able. This shameful possibility is the 
direct product of the exaggeration of con- 
tagiousness in relation to disease. Actu- 
ally, the medical crank who holds that no 
disease is contagious, would be a safer 
man on a health board than is the crank 
who represents the other extreme of be- 
lief. These extreme and outrageous do- 
ings of health boards work tremendous 



36 PREVENTIVE MEDICINE 

hardships upon business men, and,, 
through their psychologic effects, greatly 
increase the particular disease which the- 
board thinks it is fighting. Health boards 
are all right as long as they keep within 
the limits of straight, every-day sanity, 
but when they lose their taws, and g<y 
clambering up the ultimate vistas of med- 
ical vacuity, they are considerably less 
than no good. The remedy will consist 
in always electing deep and wide men,, 
who have spent half a life-time in prac- 
tical service. 

GERM THEORY 

It is too early to say that the germ 
theory has put the science of medicine 
upon a new footing. It is not absolutely 
certain that it is not too early to say that 
it is patting it upon a new basis. The 
science of bacteriology is scientific, and it 
is wholly consistent and beautiful, but its 
relationship to Medicine is very far from 
established. This new, and very fascinat- 
ing science has a way of postulating the 
necessary infallibility of certain therapeu- 



PREVENTIVE MEDICINE 37 

tic procedures, the events of which are, 
about always, disappointing. Koch, in 
his tests with reference to phthisis, mistook 
<a sciolistic ought for a scientific is, and 
these nice nuances, in relation with the 
false and the true, have been misleading 
others ever since. The bacterial enthus- 
iast derives his zeal from the misread 
shoulds of the science, not from doubtless 
results. Thus disease is, bacteriologically , 
twenty times as contagious as it is in fact, 
but the enthusiast accepts the bacteriolog- 
ical should, and rejects the actual is. If 
he is a member of a health board, he 
projects his error upon the people, and 
whether he is on the board or not, 
he ceaselessly clamors for laws which will 
conserve and perpetuate his error. Phy- 
sicians of this class are, naively enough, 
enemies of both public health and public 
peace. 

For a long, long time, the profession 
has been laboring to circumvent empiri- 
cism — to actualize a point of departure 
which is opposingly related to the empiri- 
cal method. Does this, or does it not 



38 PREVENTIVE MEDICINE 

amount to postulating a thither end of 
therapeutic art, and attempting to work 
from that to its hither end? After all, 
there is nothing even putatively certain 
in serum therapy, which is not the out- 
come of experiment, i. e., empiricism. 
But the tireless endeavors of our original 
investigators along this germ line are, to 
the last degree, commendable. These 
men are seeking therapeutic definiteness ; 
they are trying to replace therapeutic 
chaos with therapeutic science. In their 
confidences, born of the fatuous inci- 
dences of a new science, they will make 
mistakes, but every mistake is worth its 
weight in inerrancy. If not directly, 
then indirectly, much may yet come out 
of bacteriology in its relation to medicine. 

medicine's rank 
Medicine is not yet honored according 
to its deserts. It can hardly be doubted 
that so important, so grand, and so com- 
manding an institution as Medicine — 
modern Medicine — will soon be repre- 
sented in the President's cabinet. A trend 



PREVENTIVE MEDICINE 39 

of opinion favorable to this consumma- 
tion, is setting in with increasing insist- 
ency in the higher circles of thought. It 
may be stated as an axiom that what will 
benefit the medical profession will benefit 
the people. With a supreme representa- 
tive at the head of the nation, it would 
not take long to eradicate State lines in 
their relation to diplomas ; to perfect a 
rational general sanitary policy, includ- 
ing quarantine regulations ; to get prac- 
tical results out of general statistics, 
and to do many other things which, in 
the end, would be of vast benefit to the 
people. The agitation of this question 
should be kept up until the end is at- 
tained, and Medicine, in the dignity of 
its mightiness, shall step into its proper 
rank. 



PART SECOND 



CLINICAL MEDICINE 



NOT with the purpose of making this 
work unique, but for the sake of all 
that preventive medicine can mean, I now 
wish to present a subject which, in many 
of its aspects, may be said to be new. In 
the nature of things, progress is impossi- 
ble without assertions of that audacity, 
or daring, which we call iconoclasm* 
We all hate iconoclasm, and shrink from 
the iconoclast, but fit is one of the para- 
doxes of evolution] , however we may shun 
Iconoclasm in the beginning, we embrace 
it in the end. Exhausted iconoclasm is 
accomplished progress. Fully conscious 
of my danger, I take the risk of immedi- 
ate condemnation in the discussion and 
championship of what I believe to be the 
truth. All that follows will depend, for its 
legitimacy, upon the eternal correctness 
and justification of the principle of casual 
treatment. Perhaps nothing else in the 
Healing Art, as it exists at present, has 

41 



42 PEEYESTJTB MSDWISB 

so direct a bearing upon Preventive Med- 
icine. 

At the outset, it will be profitable to 
make a general survey of that aggregation 
of facts, real and possible, which consti- 
tutes Medicine. What are the boundaries 
of the Art Curative? A large question 
indeed, but not so difficult of answer. 
Man, being a cosmic epitome, the limita- 
tion of his hedonic and opposing relation- 
ships are coincident with those of the 
physical and the metaphysical, i. e., they, 
are in parity with the infinite. As related 
to the Healing Art, the various elements 
of this unbounded domain fall into five 
great divisions — the psychologic, the hy- 
gienic, the chemic, the mechanic, and the 
drug-therapeutic. Physiological optimism 
forms the back-ground of the whole. 

The ratio of psychology's importance 
is exactly one-half. We are half matter 
and half mind. As in all other cases, 
action and reaction between mind and 
matter are equal. The mission and des- 
tiny of mind can be no higher (at least 
in a scientific sense) than are those of 



PREVENTIVE MEDICINE 43 

the body, for they are co-equal in all their 
functions and phenomena. 

The relation of hygiene to the whole 
may be fairly estimated at one-fourth. 
The other fourth is divided between 
chemics, mechanics, and drug-therapeu- 
tics. The drug relation is about one-half 
of one-fourth, i. e., one-eighth. 

At first glance, this scheme will seem 
to magnify psychology and minify drug- 
therapeutics. It can be easily shown 
that this is not the case. To merely 
remember that mental shock will as 
surely extinguish life as will physical 
shock, is sufficient with reference to 
psychology. From this supreme test, down 
through every gradation of material and 
mental relations * this equality of actions 
And reactions is conspicuously evident. 
How Christian Scientists, and other high- 
perched dreamers get over this, is a 
puzzle to me, Perhaps they just fall 
over it. 

As to-the one-eighth. It must be real- 
ized that this does not mean that only 
one-eighth of all diseases require drugs. 



44 PREVENTIVE MEDICINE 

Perhaps three-fourths of all diseases are 
susceptible to drug help, while it is cer- 
tain that no disease was ever cured by 
drugs alone. There are cases in which 
the cure will depend seven-tenths upon 
drugs. The same is true of psychology, 
hygiene, chemistry and mechanics. To 
one who is suffering from an over-loaded 
stomach, we give an emetic, and he is re- 
lieved. This cure is seven or eight-tenths 
mechanical. Psychology, hygiene, chem- 
istry or drugs (in the truly therapeutic 
sense) could have done him but little 
good. So it is all through the category 
of grand. divisions. 

From these considerations, it is easily 
seen that drug-giving pervades a large 
area of Medical Art. One-eighth seems 
like a small fraction in this medical con- 
nection, but it represents an experimental 
and observational scope whose limits are 
lost in the infinite. Will one-millionth 
of all the potentialities and possibilities of 
this marvelous one-eighth ever be reduced 
to actual and active utilities? I could 
wish the fraction were one-thousaudth > 
instead of one-eighth . 



PREVENTIVE MEDICINE 45 

DRUG THERAPY 

Most of the rest of this work will be 
devoted specifically to drag therapy. 
It is my purpose to be frank and out- 
spoken, throwing myself in relation to 
the fairness and common sense of my 
brethren for justification. 

About all the errors and abuses in 
practical therapeutics result from an 
ignorance of, or disregard for, certain 
fundamental principles. These principles 
will be stated in the form of formulae or 
axioms, which will be briefly discussed. 
The first proposition is as follows : 

The right drug, given in the right quan- 
tity, at the right time to the right case, will 
makk for cure. 

This is submitted as an axiom. Its 
truth is disputed by a considerable class 
of intelligent people, but it is notable 
that almost none of them has had prac- 
tical experience with drugs. Let them 
ponder this ultimate fact, or rather, these 
final facts : The animal organism is, in 
itself, self- sufficient; no disease arises in 
it de novo ; it is affected by environal re- 



46 PREVENTIVE MEDICINE 

lationships alone, among which is included 
heredity. It is, in itself, perfect in balanc- 
ive endowment and in self-perpetuity, and 
it can be adversely affected only by things 
external to itself. That the drug — a 
natural enemy to the system — is as legit- 
imate an element of our environment as 
the surgeon's knife is, will be shown later. 
Any cures effected by mentalists, are nec- 
essarily results of environmental manipu- 
lation. This they cannot manfully and 
honorably deny. Later too, will be pre- 
sented a statement of truth which de- 
pends upon a hint of Nature's in justifi- 
cation of the use of drugs, that holds all 
the force of a Cosmic Rescript, and 
which the religionist would interpret to 
be a divine ordinance. It is certain, 
anyway, that the profession will accept 
the proposition as sound, and that is the 
main thing. The next proposition is the 
following : 

What ivill make a well man sick, wiU 
make a sick man sicker. 

The consistency of verbal meanings 
alone, enforces the truth of this. But 



PREVENTIVE MEDICINE 47 

back of this, additionally, is the vast 
Stress of all analogy. Remembering that 
sickness does not alter the quality, or 
method, of vital responsiveness, how can 
any one fail to see the verity of the axi- 
om? Nearly all doctors jump to the con- 
clusion that the proposition rules out the 
use of drugs, and that is why they oppose 
it. It will not require many words to 
show that this is very emphatically not 
so. No one denies that the surgeon's 
knife is a remedial agency. Now is it 
any more an enemy to tissue integrity, 
and nerve stability, in the sound man 
than in the sick man? You know it is 
not. You know that while it is saving 
the patient's life, it is increasing his vital 
exhaustion. Quinine is a remedial 
agent. Won't it cinchonize the patient, 
derange his nerves, etc., as certainly as 
it will do these things in the well man? 
This will not be disputed. Is not the 
drug poisoning added to the patient's ex- 
isting disability? We know it is. Is not 
the total of the patient's illness increased 
to this extent? We know it is. Is it not 



48 PREVENTIVE MEDICINE 

a fact that to. increase one's sickness, is 
to make one sicker? We know this to 
be true. 

The superficial thinker may object that 
the drug sickness replaces that of the 
disease, with the conclusion that there- 
fore the amount of sickness has not been 
increased. To be practical : Thousands of 
persons who took only enough of quinine 
to effect a cure, have been left partially 
deaf all the rest of their lives. It not 
only added to the total of sickness within 
a given time, but entailed a life-long 
ailment. Even if it were true that a drug 
effects the cure before it is swallowed, it 
adds its deleterious effects to the sum of 
the distress the patient has already en- 
dured. This is it : A price is attached to 
the obtainance of every desirable thing. Na- 
ture would have to stultify herself to 
make an exception in the case of cure by 
drugs. The old therapeutic proverb is 
true: "Drugs are double-edged tools." 
They are more than that; they are an- 
archists and desperadoes. After all, the 
cure is only incidental (accidental?) to 



PREVENTIVE MEDICINE 49 

the general or local riot the drug raises. 
This feature of the question will be dis- 
cussed later. If the proposition, What 
will make a well man sick, will make a 
sick man sicker, is not true, then it is not 
true that "Like causes produce like, ef- 
fects." The axiom stands. 

Does this great fundamental fact con- 
flict with the idea of drug therapy? Most 
emphatically, no, it does not. On the 
contrary, the axiom embodies the only fact 
in existence which justifies the use of drugs. 
Having accepted the axiom (and we have 
seen that its rejection is impossible) , we 
are made to realize that drugs, when 
ingested, are the enemies of the system, just 
as are all other foreign substances when 
swallowed. [Note that this forces us to 
drop the drug-food idea.] If we did not 
know from the naked force of common 
sense, we would know by the mountains 
of evidence there is, that drugs are ene- 
mies of the animal organism. Addition- 
ally, we have learned from the aggregated 
experience of the profession, that each 
drug is a specific enemy of a specific part 



g© PREVENTIVE MEDICINE 

of the system. Each drag possesses a 
hostile affinity for a specific tissue, or or- 
gan, or part. There is no better estab- 
lished fact in therapeutics than this. 
Drugs being enemies, not friends, of the 
system, do not cure by supplying lacks, 
chemical or histogenic, nor by any form 
of integrative cosseting. They cure by 
shock, general or local, or by both. To me, 
the shock philosophy of cure seems im- 
pregnable, for besides being buttressed by 
all there is of medical logic, it is con- 
firmed by all the experiences and obser- 
vations of all the people that ever lived. 
What layman, and particularly what 
physician, cannot recall non-medical 
shock cures? I can recollect a score of 
such cures. Two or three may be men- 
tioned. A lady who was a sufferer from 
chronic rheumatism was thrown from a 
horse into a frozen pond. The shock was 
great, but it permanently cured her rheu- 
matism. A lady patient of mine was 
having a siege of hysteria. She was in 
the habit of having such attacks three or 
four times a year. In this instance, 



mBYBtfTtVB MEDICINE 5J 

while she was at her worst, her home was 
burned. It cured her almost in&tantly, 
and her besetting ailment did not recur 
again for more than a year. Scores of 
other illustrations could be given, but 
t&ey are not needed ; everybody has wit- 
nessed such cures. Putting hygiene out 
of account, it is a fact that no one of us 
has ever witnessed a cure that did not 
depend upon shock. In the brutal past 
of Medicine, if it is true that millions 
(with weak vitality) were killed by drug- 
shock ; it is also true that thousands, who 
possessed enough of rebound, have been 
cured by horse doses of even the wrong 
drug. Thus, it is seen that Nature's 
providence liad made it impossible for 
even the crudest of drug methods to 
wholly circuifcvent her. 

If the shock thoery is true, it would 
seem that obstruction is the primary intra- 
systemic cause of disease. This obstruc- 
tion would be located in some nerve cen- 
ter, thus preventing the innervation of 
the part to which it is specially related. 

This would at least furnish the 



52 PREVENTIVE MEDICINE 

1 ' ground plan " of a form of illness . This 
inceptive below-pvness would be an in- 
vitation to germs, and these would give 
this mere subnormality specificity. We 
know that without this pre-existent de- 
pression, the microbes will be fought off. 
If it is true that any of the laboratory 
antitoxins will neutralize the poison in- 
cident to bacteria in the blood and tissues, 
then serum therapy gives us a double-bar- 
relled method of cure — we get in it, both 
a shock effect and a chemical effect. We 
do know that, after all, Nature does the 
curing, and we know, or should know, 
that our attempts at assistance must, in 
the end, be in parallelism with her method. 
To rid the system of microbic toxins, she 
directs her efforts against the cause of 
these toxins. It would be such a happy 
thing if it could be demonstrated that the 
serum method does — either absolutely or 
relatively — multiply the phagocytes. An 
antitoxin serum does this relatively, if it 
destroys the pathogenic, and only the 
pathogenic microbes. 

The shock theory seems to be invulner- 



PREVENTIVE MEDICINE 53 

able. Its truth is exemplified even in 
spontaneous cures, so called, for every 
recovery is the result of a battle between 
the vis medicatrix naturae and the foreign 
invader, and battle means shock. Disease 
is always whipped out, never coaxed out 

If there is a rat in a house, an earth- 
quake may shake the house up sufficiently 
to drive the rodent out, but it would be 
hard on the house. If we can locate the 
rat, and send a cat in after him, we will 
get him without damaging the house. 
This principle is coming to be recognized, 
and deferred to by all up-to-date physi- 
cians, of whatever school. We are get- 
ting used to the therapeutic slogan, 
"Small doses, frequently repeat ed." A 
series of small taps aggregates a heavy 
jolt, but anyhow, not much of a jolt is 
needed, since the indirect, and merely 
incidental shock of a part, as a conse- 
quence of a great and general shock, is 
comparatively small. 

The popular feeling about it is that 
quality, as much as quantity, enters into 
the question of drug-shock. The fact is, 



54 PRBVBNTTVB MEDtCESB 

though, thai the essence of shock is not 
variable. The erroneous method of 
thought about it depends upon a confu- 
sion of the elective idea with the quality 
idea. Drugs have an inimical affinity for 
different parts. The discriminative phy- 
sician takes advantage of this fact, and 
sends his cat after the rat by a direct route. 
This is a pervasive fact, and is without 
absolutely special relation to any particu- 
lar sect. The ultimate philosophy of cure 
by direct medication, as I see it, is this : 
The drug, electing a particular part upon 
which to express itself, raises a disturb- 
ance there. In the tumult, the morbid 
tangle is shaken out, and previously de- 
flected vital energy falls into normal line. 
The quantity of medicine required in a 
given case will depend upon the area of 
the primal lesion. Thus, syphilis, scrof- 
ula, etc., require much medicine. Yog 
must throw into a patient, suffering with 
periodic malaria, thirty to forty grains of 
quinine within forty-eight hours. On the 
other hand, only a few drops of aconite 
and belladonna will cure a tousilitis, and 



PREVENTIVE MEDICINE gg 

the same is trae of Phytolacca in threat- 
ened mammary abscess. la chronic dis- 
ease, and disease of large area, larger 
doses, less frequently repeated, are pre* 
ferable to "small, and frequently repeated 
doses." That, at least, has been my ex- 
perience. 

The third proposition is : 

Food is food, and medicine is medicine. 

While this enunciation instantly and 
irresistibly commends itself to our com- 
mon sense, its truth is practically denied 
by about every physician. The feeling is 
that food merges into drugs, and vice 
versa. That this notion is erroneous, and 
very calamitously so, can be quickly 9 and 
easily shown. 

That there is a difference between food 
and medicine, is made sufficiently evident 
by the fact that neither the word food, 
nor drugs, can be dispensed with — neither 
word is redundant. That alone estab- 
lishes the axiomship of the proposition, 
but there are many more irrefutable argu- 
ments along this line which will come out 
later. A putative argument against the 



56 PREVENTIVE MEDICINE 

soundness of the proposition, depends up- 
on the fact that food contains, in combi- 
nation, drug elements ; and drugs, in like 
manner, contain food elements. This is 
like contending for the identity of a stone 
culvert and a stone house, because they 
both contain stone. Those who project 
this argument, do not stop to think of the 
difference there is between a culvert and 
a house. With equal reason they might 
contend for the identity of all things be- 
cause all things are reducible to the four 
primary gases. We live in the proxi- 
mate, not the ultimate, and the difference 
between the things to which vre are re- 
lated, depends upon their functions, so 
far as our weal or woe goes. The function 
of food is to nourish and sustain the 
body ; the function of drugs is directly 
the opposite of this. 

The most cherished reason why doctors 
deny the proposition's axiomship, is be- 
cause it is in conflict with the tissue-feed- 
ing notion. Like many another fallacy, 
this idea of directly feeding the tissues, 
has seaped down the ages, and through 



PREVENTIVE MEDICINE 57 

the repetitions of heredity, has become a 
part of the very constitutions of medical 
men . Very few of even our most thought- 
ful men, have been able to cast aside all 
prejudice, and impartially investigate the 
subject. This taint of the ages has made 
almost all doctors impervious to even the 
hardest and keenest of opposing logic. 
While this conservative fixity has its 
place in the economy of things, it is still 
true that heresy — honest heresy — is, as it 
always has been, the hope of the world. 

This axiom directly opposes the tissue- 
feeding theory. It is the function of 
food to feed;- medicines never feed. If 
something called a medicine feeds, then 
it is not a drug, it is a food. Medicines 
cure, not by supplying a lack in the sys- 
tem, for there can be no drug lack in the 
organism, but by general, or local pertur- 
bation . Medicine cures dynamically , and 
this results from its heterogeneity with 
reference to the animal organism. Foods 
are homogeneous to the system. Food is 
food j and drugs are drugs. 

For untold millions of years, Nature 



58 FREVEXTrVW MWDICIXE 

has been adapting, first vegetable, a&4 
then animal, life to their environment. 
Out of the fundamental consistency and 
necessity of things, this process of adapt* 
ation was also a process of establishing 
assimilative limitation. Man is a micro- 
cosm in natural, not artificial, relations 
and possibilities. The chemist's liioe, 
for instance, is not Nature's lime, and 
therefore it is not assimilable. Nature 
gives us no isolated chemicals ; they are 
always in combination. It is to these 
natual combinations that the metabolic 
and more purely differentiating func- 
tions are fitted. Common salt does not 
exist, as such, in food, and that which we 
use as a condiment is not truly assimi- 
lated. It is a sort of food annex, and 
probably helps to prevent degenerative 
fermentation, etc. By very fiat, then, 
impressed in this great evolutionary fact, 
nothing but natural food combinations is 
assimilable. 

In connection with the profound phase 
of physiology just discussed, we catch a 
hint of mighty significance. This hint 



PREVENTIVE MEDICINE 5® 

inheres in the fact that everything the 
gastric juice will dissolve, gets into the 
circulation. This does not depend upon 
a lapse in conservative vigilance, &?r 
Nature is never guilty of lapses. This 
major fact, together with the fact that 
drugs are disturbers of functionl equilib- 
rium, i* all that make drug meditation, 
possible. The gulf between the absorbing 
and the assimilating limitation, Iwlds ail 
the potency and promise of drug possibility. 
In reference to the justification of drug 
therapy, it is scarcely less than a Cosmic 
Edict, The religionist might well call 
the use of drugs divinely mandatory. 

So far, only general and comprehensive 
reasons have been given to show why the 
tissue-feeding idea is fallacious* There 
is no end to irrefutable specific argu- 
ments against it, but only a few can be 
presented here. 

The leading tissue-food, so called, is 
iron. This drug has been the erux of the 
ages. This is a historical fact. It has 
been such on account of its non-assimila- 
bility. This too is a historical fact. It 



60 PREVENTIVE MEDICINE 

has been the vaulting ambition of doc* 
tors and chemists, to chemically dupli- 
cate Nature's iron. This, also, is a his- 
torical fact. The question suggested in 
this connection is this : If they should 
succeed in reproducing Nature's iron, 
what would they do with it? If two glasses 
of water are poured from the same pitch- 
er, what sane reason is there for prefer- 
ring the least applicable one to the other? 
These questions are respectfully sub- 
mitted. 

If one tissue can be directly fed, why 
can not they all be so fed? This aspect 
of the subject was earnestly contemplated 
by an ingenious, though superficial, 
thinker, with the result that he erected a 
new, and exclusive, medical system, 
based solely upon the tissue-feeding idea. 
Why not? If there is a law of drug cure, 
it is necessarily the law of drug cure. 
There cannot be two laws of drug cure, 
any more that there can be two laws of 
gravitation. It did not stretch even his 
perspicacity to cocoon this fact. Nature 
does not provide differing laws in alternate 



PREVENTIVE MEDICINE 61 

relationships. Schuessler very correctly 
concluded that if the salts of iron are as- 
similable, the salts of all other minerals 
are the same. At this trembling junc- 
ture, a triumphant "eureka!" must have 
burst from his soul, for he had logically 
created the true system of medicine-— he 
had solved the puzzle of the ages! He 
knew, both by reason and instinct, that 
if one item of his system were true, no 
other system could be true. It was a 
glorious moment for this ambitious man. 

This "biochemic" system is referred to 
here, in order to make it plain to you, 
that he who practices any of the system, 
without adopting it in toto, is grossly in- 
consistent, and is morally guilty of mal- 
practice. This will be clear to any one, 
it seems to me, who is fair in his deduc- 
tions. 

There is nothing else within the scope 
of preventive medicine so insistently 
called for, as the prevention of wrong 
medication. None but causal medication is 
right From center to circumference, the 
tissue-feeding idea is opposed to causal 



02 PREV&VT1V& MEDICINE 

treatment. Under the tissue- feeding fal- 
lacy, the symptom is infallibly construed 
to be the disease. You see this especially 
in the treatment for the symptom, 
anemia. Perhaps there never was a case 
of idiopathic anemia, but even if there 
were such a disease, the attempt to sup- 
ply an intra-systemic lack with a drug, 
touches the extreme of absurdity. Yet, 
about all doctors direct their treatment 
squarely against the disease effect, anemia. 
Instead of going for the head of the dis- 
ease, they nip at its tail. The tremend- 
ous force and tenacity of orthodox con- 
servatism is conspicuously illustrated in 
all the works on practice now in exist- 
ence. Each author, after naming a few, 
or all of the fifteen or twenty diseases un- 
derlying anemia, and after stating ex- 
plicitly that it is merely a symptom, will 
gravely sum up the treatment in a single 
word — iron. Think of it : iron for dys- 
pepsia, amenorrhoea, irregular menstru- 
ation, diarrhoea, purulent discharges, 
typhoid and other fevers, splenitis, 
Brfght's disease, excessive lactation, leu- 



PREVENTIVE M EDWINS gj 

corrhoea, phthisis, calenture, love-sick- 
ness, unhygienic conditions, etc., etc., etc. 
Out of half a dozen people who have 
been eating at the same table for months, 
of years, one of them will fall into a con- 
dition of anemia. It is likely to be the 
fifteen or sixteen-year old girl of the 
group. This, despite the fact that her 
food contains twice as much iron as she, 
or any of the rest of them, can assimilate. 
There is one happy feature in the situa- 
tion, and that is this : she cannot possi- 
bly make a mistake in her selection of a 
doctor. Whatever the doctor's school, 
or educational attainments, he will know 
exactly what to do in this case — that's 
dead easy. If he reason any at all in the 
matter, be will have to assume first, that 
the symptom is the disease; second, that 
the girl's food does not contain enough 
iron ; third, that chemical iron is more 
assimilable than food-iron; fourth, that 
the basis of disease is a salt-lack; fifth, 
that this lack must be directly supplied, 
If he reasons further, he may wonder why 
and when, the cells will ever again be- 



64 PREVENTIVE MEDICINE 

come reconciled to natural food-iron. But 
he will let all that pass, and he will 
give her iron, for is not that classical? 
Whether consciously or not, all doctors 
who give iron for anemia, reason this 
way: "I perceive that in this case the 
system will not take up iron ; therefore > 
I shall give her — iron." 

If the theory under which iron is given 
is correct, what is the use of disturbing 
the stomach and bowels? Why not ex- 
amine a drop of the patient's blood, and 
after having discovered just what and 
how much of it is lacking, inject it into 
the circulation? Would not that directly 
dissipate the lack, and could not the case 
be thus cured in a few minutes? In this 
case the pure, isolated salt would be put 
just where you want it. If iron is the 
thing needed in anemia, what is the use 
of associating with it such positive drugs 
as strychnia, arsenic, hydro-chloric acid, 
etc., etc.? Note, that the effectiveness of 
any iron preparation runs evenly with 
the efficacy of its associates, and that 
"whether the preparation does more, or 



PREVENTIVE MEDIVINE 65 

less good, always depends upon the degree 
in which these associates are indicated. 
In this connection, I wish to acknowledge 
that many of the iron preparations on 
the market are good medicines, but I in- 
sist with all the confidence derived from 
reason, experience, and observation, that 
they are good in spite of the iron ingredi- 
ent. I have made hundreds of tests along 
this line, and always with the result of 
confirming the logical reasons and con- 
clusions presented in this little work. It 
does seem to me that all the foregoing 
arguments, taken in connection with the 
fact that all ingested chemical iron is re- 
coverable from the feces and urine, and 
the fact that cures are never sought from 
the use of straight, naked iron salts — it 
does seem that these should be conclusive. 
Although I do not believe that iron 
possesses any other medicinal property 
than astringency, I am not dogmatic on 
that point. It may be cautiously admit- 
ted that there are possible conditions in 
which the oxydizing property of iron is 
theoretically helpful. It is certain that 



66 PREVENTIVE MEDICINE 

all the misnamed tissue salts are good 
medicines, but never remedies at all in a 
tissue-feeding sense. Phosphorus has 
quite a range of application, but it won't 
cure brain-fag, neurasthenia, etc. Lime 
may be more than an antacid, but it 
won't cure rickets, delayed dentition, etc. 
And so, with reference to "tissue foods" 
all through. 

If the usual doctor would do more 
thinking for himself, and less copying, 
how much better it would be. As all 
reasonable people will agree to this, I 
feel acquitted of the excessive self-appre- 
ciation that would otherwise be exhibited 
in the enunciation. 

An instance of drug-dependence, and 
servility to authority, is markedly seen 
in the prevailing method of treating sum- 
mer complaint. Within a few years its 
therapy has advanced from one phase of 
symptom treatment — treatment by ant- 
acids; to another — treatment by anti- 
septics. The treatment in both cases, is 
directed without a qualm or a quaver, 
against the effects of the disease. Neither 



PREVENTIVE MEDICINE 67 

primary acidity, nor primary sepsis, is 
^vor the cause of the disease; either, or 
both, may result from it. The predispos- 
ing cause of the disease is the depressing 
effect of a prolonged high atmospheric 
temperature, alone, or this in connection 
with unsanitary conditions. The im- 
mediate cause is indigestion. Particularly 
in the case of infants, almost no medicine 
is needed in the correction of this con- 
dition. In most cases, it will be enough 
to rid the stomach and bowels of undi- 
gested and fermenting material, with a 
dose of castor oil. All that is then left to 
do, is to regulate the child's diet. The 
nursing child of a healthy, unworried 
mother, seldom has any serious stomach 
or bowel trouble. It is the bottle-fed 
ones that suffer and die. The way to 
•cure the child's indigestion is to feed it 
nothing which it cannot digest. In many 
instances it is necessary, in the begin- 
ning, to make the food one part milk, to 
-seven or eight parts water. The guide or 
-gauge in the case is dilution. Dilute its 
milk till curds and flocculi disappear 



68 PREVENTIVE MEDICINE 

from the discharges. In extreme cases, I 
have employed a weak solution of gum 
Arabic in the start. The mother is in- 
structed to be governed by the character 
of the stools, diluting, or not, according 
to the appearance or non-appearance of 
curds in the passages. She is to increase 
the strength of the food as the stomach 
will bear it. The prepared baby foods 
have been found useful in some cases. 
The mother soon becomes an expert in 
this matter. The rapid improvement 
that always takes place, stimulates and 
encourages her to the utmost care and 
precision in the dilution of her baby's 
food. For a moral reason, if for no 
other, a little harmless medicine may be 
given. In most cases the indicated 
remedy will be nux and ipecac, or aconite 
and ipecac ; more frequently the former. 
Let the doses be so small that they will 
hold mere suggestions of the drugs. You 
can hardly get them too small. I have 
employed this method in summer com- 
plaint for the last ten years, and it has 
convinced me that ninety-five per cent 



PREVENTIVE MEDICINE 69 

of all cases of this disease — take them as 
they come— can be saved. You see, it is 
causal treatment, and is therefore the 
tight treatment. 

ANTIPYRETICS 

Another instance of purely symptom- 
atic treatment is furnished in the use of 
antipyretics. If there is such a tiling as 
idiopathic fever, I do not know what it is. 
Feyer is always a symptom . A child has 
aboil. It is accompanied by fever. Is 
the fever the primary lesion accompanied 
by a boil? A has inflammation of the 
lungs, with fever. Has the inflammation 
been produced by the fever? Later in 
the case, has heart fatigue produced en- 
gorgement of the lungs, or is the latter 
responsible for the former, and is it 
philosophic to whip up the tired heart? 
Inflammation of Peyer's patches is at- 
tended by a fever. Is this inflammation 
sequential to the fever? Is fever, in 
any variety of any morbid condition, the 
disease, and are all itises, etc., its 
symptoms? If this is not true, can any 
one give the smallest fraction of the 



70 PREVENTIVE MEDICINE 

smallest sort of a reason why antipyretics 
should ever be used? Does any one 
know of an antipyretic (except tepid 
sponging — not cold bathing) which is 
not a cardiac depressant? After a little 
reflection — shot through with a remem- 
brance of the coal tar products — is it not 
clear why death from "heart failure* 1 has 
become the "shuffling" vogue? Does not 
fever rise from local disturbances, as 
smoke rises from a fire? Would you 
throw water on the smoke in order to ex- 
tinguish the fire? I would no more think 
of using an antipyretic than I would 
think of curing acid dyspepsia with the 
bicarbonate of soda. Tear away from 
these monstrous abuses, friends, and 
adopt causal treatment, if you die for it. 

ANODYNES 

In this relation, a bottom question is 
suggested : Can pain do more harm than 
its cause can do? If not, the use of an 
analgesic is never i}m % a>fK*d'kqJly justified , 
though in a class of cases it may be senti- 
mentally justified. It must be conceded 
that the simultaneous existence of pain 



PREVENTIVE MEDICINE 71 

and its cause, costs more, for tlie time, 
than does the cause alone, but does the 
pain cost as much as the cause, uncura- 
tive drug action, and delayed recovery, 
combined? In its ultimate ethical sense, 
does it ever pay to borrow? And is it 
not true that anodynes force the system 
to "borrow from the future? " Again, is 
it certain that the extent to which an 
anodyne relieves pain, is the exact meas- 
ure of reparative retardation? It would 
be so, if psychologic favor did not result 
from the patient's increased comfort and 
hopefulness under an anodyne. What- 
ever abstract view may be taken, of it, it 
is a practical fact that thoughtful, and 
conservative physicians always deplore 
the necessity for obtunding sensation. 
When they employ an analgesic, they are 
aware that they are not practicing 
therapeutics, and their feeling is that they 
have, possibly, chosen the lesser of two 
evils. A very important adverse factor 
in the case, depends upon the possibility 
of drug addiction. In reference to the 
use of anodynes, it is safe for the physi- 



72 PREVENTIVE MEDICINE 

cian to be controlled less by his heart 
than his brain. 

STIMULANTS 

There is certainly less excuse for the use 
of stimulants than there is for the use of 
anodynes. Whether a stimulant has ever 
done any good, is an entirely legitimat3 
question. That stimulants have done 
unmeasured harm, we all know. They 
are never justified in a tonic sense, for 
they are not tonics. It is not susceptible 
of proof that stimulation ever did "tide" 
a disease process "over a crisis." A 
stimulant will call into immediate ex- 
pression a portion of the patient's reserve 
vitality. Whether this simultaneous ad- 
dition and subtraction is not equal to a 
1 'stand-off," is a question. I feel that — 
considering the doubtful utility of stimu- 
lants, and the certain danger of them — 
the physician who fights the shyest of 
them is making no great mistake. 

QUACKKRY 

First, what is a quack? It used to be 
the fashion to denounce all doctors as 



PREVENTIVE MEDICINE 73 

quacks who were without the ranks of the 
regular school of medicine. That has 
passed. The broadening and softening 
influence of our later civilization has 
made larger men of U3. In those days of 
intolerance, the rust of autocratic ages, 
with their dogmatic austerity and smug 
magisterialism, was still on the profession. 
Forty years ago, when I entered the 
practice of medicine, the feeling against 
irregulars was very bitter, and it did not 
add any to one's good standing to palli- 
ate their protestantism, even just a little. 
In those days, the regular doctor wa3 a 
physician and an American, but anyhow, 
a physician. Now, the representative 
physician of the regular school, is an 
American and a physician, but anyhow, 
ati American. He is saturated with the 
spirit of freedom and fair play, and he 
does not * condemn a man as a quack 
simply for differing from him doctrinally. 
He knows that there is no difference be- 
tween his school and the others, in any- 
thing excepting therapeutics, and he un- 
derstands well why this difference can 



74 PREVENTIVE MEDICINE 

exist. He realizes that therapeutics is 
too shaky a frabric to brace against in a 
fight. He feels that as long as there is 
no visible clinical difference in his favor 
when statistics are compared, he is not 
justified in branding his differing neigh- 
bor a charlatan. He does not even call 
Ostopaths, Christian Scientists, Mental 
Healers, etc., quacks ; he calls them one- 
ideaists — inchoate would-be V. Of course 
that is just what they are, and there is no 
sin in it — just shortage. 

The quack is such, generally, more 
from moral obliquity than from medical 
incompetency. Most of them have hang- 
ing on the walls of their offices diplomas 
from reputable medical colleges. The 
clinical record of many of them may be 
as good as that of the average legitimate 
physician. Their great sin consists in 
trading on the innocence and credulity of 
the afflicted. Their self-eulogy is disgust* 
ing enough, but the conjunction of this 
with fascinating but utterly irredeemable 
promises, is grossly criminal — it is to 
obtain money under false representations. 



PREVENTIVE MEDICINE 75 

Their complete failure to justify, in the 
event, the expectations raised in their 
victims by their blatant stultiloquence, 
adds to the fleeced contingent, and fleeced 
people are not morally wholesome. Per- 
haps the worst form of quackery is that 
represented by those unspeakable frauds 
who play the "pious racket/' thus com- 
mercializing human gullibility in its 
connection with the most sacred instinct 
of our nature. Think of the continent 
of "gall" that is required to pose as a 
saint or prophet, and to profess to have 
what a ward bummer would call a pull on 
God. This touches the limit of religio- 
medical rot. Until human nature is re- 
constructed, the quacks, like other va- 
rieties of criminals, will always be with 
us. We simply cannot help it, and must 
do the best we can with reference to this 
great evil. 

This quack subject has been discussed, 
because quackery is both a physical, and 
a moral depressant. If, medical legiti- 
macy is right, it is right because it con- 
serves the physical weal of the people. 



76 PREVENTIVE MEDICINE 

To oppose medical legitimacy then, is to 
oppose something that is right in its re- 
lation to mankind. Quackery opposes 
legitimate medicine with both its horns 
and all its hoofs. 

PATENT MEDICINES 

There is an unfairness pertaining to 
the patent medicine trade which seems to 
have never struck men in that business. It 
depends upon the fact that a patent med- 
icine does not carry with it the power to 
make its purchaser a first class diagnos- 
tics u and therapeutist. It may not be 
conceding too much to say that the usual 
patent medicine will fit one case in a 
thousand. The nine hundred and ninety- 
nine in whose cases the medicine was not 
indicated, have been made a dollar poorer 
in money, to say nothing of the physical 
damage they have sustained. If you buy 
six watermelons at twenty-five cents 
each before you get one that is fit to eat, 
the. good melon has cost you one dollar 
and a half. On the same principle, the 
one available bottle of medicine has cost 
one thousand dollars in money, making 



PREVENTIVE MEDICINE 77 

no mention of damage to health. Nine 
hundred and ninety-nine people have 
been entrapped into contributing a dol- 
lar toward the purchase of a bottle of 
medicine for — perhaps a shanty-boat aris- 
tocrat. This does not seem fair, and be- 
sides, one thousand dollars for one bottle 
of medicine which cost the manufacturer 
seven cents, really seems exorbitant. 
The patent medicine man evidently has 
never studied the question in this light, 
for otherwise he would not be in the bus- 
iness. The matter, as here presented, is 
respectfully submitted to him. 

In egoism and egotism f and flamboyant 
self-advertisement, and general fradu- 
lency and detestability, the patent medi- 
cine man is neck and neck with the prac- 
ticing quack. Like the quack, he is in 
the business solely for the money there is 
in it. Like the quack, he is a beast of 
prey, and so is antithetically related to 
all that is noble, and beautiful, and re- 
deeming in human nature. There is 
some nice, elusive, ethical reason why 
the maker and vender of patent medi- 



78 PREVENTIVE MEDICINE 

cines is better tolerated by the profession 
than Is the actively manifest quack. Per- 
haps it is because his personality is meas- 
urably lost in his panacea ; so that he is 
less odiously evident. 

There is only one conceivable way of 
exterminating the patent medicine man, 
and that would be for the state to pay the 
newspaper man more for not advertising 
bis wares, than he can atford to pay for 
their advertisement. Of course this is 
— lwrk feasible. If the government would 
refuse to patent or copyright his medi- 
cine, that might help just a little, but 
only just a little, for he would continue 
to advertise and sell it as a secret prepa- 
ration. A law against the sale of secret 
remedies would not help much, for the 
fakir would publish a false formula, and 
by the force of eloquent advertisement, 
sell to the laity as the proprietary medi- 
cine man sells to the profession. There 
is no help for it — like the social evil, pat- 
ent medicine will be with us till the pro- 
fession can educate the people away from 
it. 



PREVENTIVE MEDICINE 79 

PROPRIETARY MEDICINE 

This is not an unmixed blessing. Any- 
thing which diminishes the efficiency of 
the physician is bad for the people. The 
greatest fault of the proprietary medicine 
is its extreme convenience. In too many 
cases, convenience will take precedence 
of, and override prudence. There is a 
streak of indolence, and make-shiftiness 
in all of us which inclines us to sacrifice 
the future to the present — the mediate to 
the immediate. The tendency of the 
proprietary-medicine fascination is to 
create mere formula doctors. Such doc- 
tors link together certain formulae and cer- 
tain nosological terms, and they practice 
deferentially to these twinships. They 
are wholly innocent of etiological travail, 
pathological discrimination, and the 
study of individual drug action. They 
do not have to think— -they are machines. 
Each of these doctors is an unpaid agent 
for the manufacturers of the "hand-me- 
downs" he may use, and — the manufact- 
urers don't "kick." It may be objected 
that this is true of every doctor, in rela- 



80 PREVENTIVE. MEDICINE 

tion to every drug, but the fact is, the 
doctor chooses his simples with reference 
to their quality, and not because they are 
interlabeled with disease, and are so con- 
venient. It is not denied that many pro- 
prietary remedies are excellent medicines, 
and to be forever commended, but what 
I insist on is that they are not, and 
should not be made, "the whole push." 
There are a number of proprietary prepa- 
rations without which I could hardly 
practice medicine. An important factor, 
in relation with proprietary remedies, 
depends upon their pharmacal elegance. 
This endows them with a tidiness, and 
esthetic incidence, which no up-to-date 
physician can afford to despise. The 
purpose of this section is, not to decry 
proprietary medicines, as such, but to 
warn the doctor against a descent into 
machinism. 



PREVENTIVE MEDICINE 81 

RESUME 

1. — The right drug, given in the right 
quantity, at the right time, in the right case, 
makes for cure. 

This proposition stands unquestioned 
by all drug-using doctors. 

2. What will make a well man sick, will 
make a sick man sicker. 

The truth of this is unquestionable, 
both for analogical reasons of its own, 
and because it stands in the place of that 
doubtless axiom: "Like causes produce 
like effects." So far from contradicting 
the use of drugs, it embodies in itself the 
only truth which justifies their use. It 
forces upon us a realization of the truth, 
that drugs, in common with all foreign 
substances, are, when ingested, enemies of 
the system, and it further enforces the 
fact that drugs cure by virtue of their 
hostility to the organism, i. e., by shock. 
Sequentially to this axiom, follows the 
axiom: 

Food is food, and medicine is medicine. 

Although this stands unshakeable, by 
the naked force of common sense, note 

6 



82 PREVEKTIVE MEDICINE 

particularly that it is necessitated by the 
rigorous truth of axiom No. %. These 
three axioms constitute the alMnvolving, 
and ultimate trinity upon which rests 
therapeutic possibility, therapeutic justifi- 
cation, and therapeutic achievemei^t. 

For years I have squared my practice 
to the bottom truths held in these axioms. 
To say that the satisfaction of working 
upon a plane of certainties, has been in- 
estimable; that I have used not more 
than one-third as much medicine as for* 
merly, and that my clinical success has 
been tripled, is — according to my person- 
al feelings — to say things which are su-> 
pererogatory, and purely gratuitous. 

Finally, I would submit that hyper- 
medication, including wrong medication, 
are directly antithetical to preventive 
medicine, and that in a deference to the 
foregoing axioms, abides the only rational 
remedy for this abuse. I would further 
submit that the other extreme, drug 
nihilism, is the direct product of drug 
abuse, and that the only rational remedy 
for this is a strict submission to the 
truths embodied in these axioms. 



PR BVBNT Prg MBDiCINB- gj 

If a haphazard system of therapeutic* 
1» net all fact, it id very far from being 
-all good. It seems to me the time »ripe 
tor such a general reconstruction of ther- 
apeutic methods as witt eliminate most 
of the grosser medical errors and abuses. 
It is perhaps a vain hope that this little 
Tx>ok will have a noticeable effect on gen- 
eral medical thought, but if it, haply, im- 
prove the clinical method of just a few, 
that much of good will have been accom- 
plished at least. I have no apologies to 
make for the position I have taken, nor 
for the manner in which I have pre- 
sented it. 

That too much medicine is given, all 
will admit. Please note the truth of 
this statement despite the fact that, al- 
though no one individual doctor pushes 
drugs too hard and recklessly, very many 
other individual doctors do. Every time 
a dose of medicine is directed against a 
mere symptom, one dose too much has 
been given. I will not insult your intel- 
ligence by insisting on this. It has 
been the purpose of the most important 



84 PREVENTIVE MEDICINE 

part of this book, to show why a purely- 
symptom treatment prevails to such an, 
enormous extent, and to outline — as it. 
seems to me — the only philosophy that, 
can remedy the abuse. 



PART THIRD 

PRACTICAL APPLICATION 

IN this division will be given illustra- 
tive applications of the principles 
i;aught. There will be some repetitions 
♦of preceding statements and examples, 
but they will refer to teachings and in- 
junctions which cannot be too often and 
insistently repeated. I shall report a few 
►cases, giving my reasons as I go along 
for each phase of the treatment. Mainly, 
-such cases will be selected as best exem- 
plify the dominant elements of my thera- 
peutic philosophy. 

CASE FIRST 

Sporadic Dysentery. — Perhaps in no 
other disease is the justification of drugs 
more manifest than it is in this one. 
Whereas, under dietetic regulation and 
liygienic strictness without medicine, an 
average case of dysentery will run on in- 
definitely, or at least many days, under 
proper drug treatment it will be cured in 
a few hours. Here mechanics, chemics* 



86 PREVENTIVE MEDICINE 

hygiene and pyscbology— including the* 
most tensive mental conservation, and: 
the morft inflwenlfcbl p^yer-^te^ll sadly 
fail. The most conscientious ^application, 
of all other means without -drugs*, will 
fail ; or at most, will vecy slowly succeed 
in only a portion of the cases. The &Ctg. 
connected with the management Of th& 
disease alone, everlastingly establish the 
verity and validity of axiom one. 

J. B. had a typical case of sporadic- 
dysentery. It bad been on hand several 
days, notwithstanding the fact tltat be 
had set his prima vise on fire with hat* 
stuffs, and corrugated it with astringents! 
I promised him a cure in 6 or 8 hours r 
provided lie strictly obeyed directions^ 
What a stimulating fact it is, that in a 
limited number of diseases we can prom- 
ise a positive cure within a more or less- 
definite period ! 

That was 35 years aga, and I ctared. 
him within the specified time with the 
old modified White Liquid Physic. Right 
here (for the benefit of drug nihilists) I 
feel justified in giving my own personal 



dysentery expeHence. I had jiist re- 
turned to my home in Harrison, Ohio, 
from a Hygienic Institute with which I 
had been associated for a ye&h I Wits 
saturated with Hygiene, and especially 
With Hydropathy. To me the teachings 
of this institute held all there Was of 
reinedial gospel — I was a thorough one- 
ideaist. I had been at home but a feW 
days when I became a victim of dyseh- 
tery. I had it bad — had it with a dia- 
bolic whirl to it, so to speak. Well, I 
hygiened it with a zeal known only to one- 
ideaists, but it dysenteried right along 
With no sigh of abatement. I had been 
treating myself thus for two weeks, and 
had reached the conviction that my case 
was incurable. Why not? If the only 
true method had failed, what ground for 
hope was left? Sifnply none. 

One day Dr. M.'L. Thomas— of sacred 
and blessed memory — passed my home. 
I was sitting on the front doorstep. My 
wan and etiolated appearance attracted 
his attention. Coming up to mc in his 
hale, eheetfy way, he said : 



88 PREVENTIVE MEDICINE 

"Why Billey, what's the matter with 
you?" 

I explained that I had an incurable 
case of dysentery. With an effrontery 
born of non-drug fanaticism, I explained 
to him how and why I knew my case to 
be hopeless. 

"Well," said he, "as you are doomed 
anyhow, you wouldn't object to my ex- 
perimenting on you a little, would you, 
especially as it will demonstrate to the 
world the inutility of drugs?" 

Being willing to die for the triumph of 
Hygiene, I consented. 

Then he said; "Of course my treat- 
ment won't cure you, but I like you, and 
I want the satisfaction of having tried to 
save you at least." 

He brought me a bottle of White Liquid 
Physic (modified) , and instructed me to 
take a tablespoonful of it in half a glass 
of sweetened water every hour till it con- 
verted my "flux" into a diarrhoea, then 
to rapidly taper off in its use. 

I followed the directions, and the fifth 
dose brought the diarrhoeal change, after 



PREVENTIVE MEDICINE 89 

which I took only a teaspoonfulat a dose 
for 3 or 4 hours- By this time I was very 
weak and gladly ate some boiled thick- 
ened milk — the diet he had perscribed. 
That treatment is heroic, but very effect- 
ive for those who can stand it, and, after 
all 9 it is not so hard to stand. Within 
6 or 8 hours after Dr. Thomas handed 
me that bottle of medicine, my dysentery 
was cured, and my unreasonable preju- 
dice against drugs was cured. Here is 
the modified formula of the White Liquid 
Physic : 

Br 

Sulphate Soda - - 3viii 
Water ... |xxiv 
Nitro-muriatic Acid - si 
Mix, and if necessary, strain after it is 
completely dissolved. Complete solution 
often requires several days. It makes a 
perfectly clear and nearly colorless solu- 
tion. In the original formula there is 
some alum, and there is twice the quan- 
tity of acid. This was Dr. Thomas' 
formula. I am proud to state that later 
he became my preceptor. I had two pre- 



#1 pntittixvtrt: xmtttxti 

emptors* Professor Shudder (<rf revtteS* 
memory) being my lifltst one, 

I have not used this remedy in my 
practice for years. It is not gentle and 
refined enough for these days. My pte&> 
ent mode of treating it (which is, if pos- 
sible, more effective) is the following : 

To a glass $ full of water, I add 5 or 4 
drops of specific aconite, and 10 or 12 
drops of specific ipecac. These tincture* 
are of the strength of a good, honest fluid 
extract. They are manufactured by 
Lloyd Brothers. There may be others 
equally good. At any rate, secure a re- 
liable make. - Of this glass mixture, I 
direct the patient to take a teaspoonful 
every hour, except the third hour, when 
he is to substitute a powder, each one of 
which contains 6 or 8 grains of sulphate 
of magnesia tuturated with 10 or IS 
grains of bismuth subnitrate. These af* 
adult doses, to be varied in quantity ac- 
cording to age, This treatment will cure 
ninety-nino ; and nine-tenths J>er cent, of 
all your sporadic dysentery cases. It is 
not quite teo rapid in its effects to the 



FlteVENVtVE MEDtCINS & 

White Liquid Physic, but is miioh mere 
pleasant. It is specially adapted to delr- 
eaile women a&d to children. 

I use the same powder in epidemic 
dysentery, alternating with it echinacea, 
ba$)tista, etc. In epidemic dysentery;, 
and even in bad cases of the sporadic 
variety, I have the colon flushed with a 
solution of the aqueous extract of ham- 
mamelis, Lloyd's hydras tis and a sug- 
gestion of sulphate of zinc. Any other 
mild, healing and antiseptic solution 
might do as wetl. The treatment of dys- 
entery enforces the truth of axiom one. 

The truth of axiom one is made equally 
piain by the use of Phytolacca and aco- 
nite in threatened, mammary abscess. 
This combination is absolutely specific to 
this condition. In a practice covering a 
period of 40 years, I have not had a sin- 
gle case of mammary abscess, though II 
have certainly had 100 cases of mam- 
tnitis. Used locally and internally in 
threatened mammary abscess, I believe 
it to be infallible. To a glass f full erf 
water, add 6 or 8 drops of specific phytfr- 



92 PREVENTIVE MEDICINE 

lacca and 4 or 5 drops of specific aconite. 
A teaspoonful of this is to be taken every 
hour, while a solution of five times the 
strength is to be applied locally. Exact- 
ly the same treatment is indicated in all 
glandular inflammations, specially in- 
cluding orchitis. 

CASE SECOND 

Rachitis. Child 6 months old. Cause— 
and it is the cause in about all cases, for 
the disease is not hereditary — unhygienic 
conditions. Lack of cleanliness, lack of 
pure air, and lack of digestible, whole- 
some, and nutritious food — these consti- 
tuted the cause. These lacks imply posi* 
tive presences f and such alone can cause 
disease. The only way in which we can 
remove an effect is to remove the cause. 
It luckily happened that I could have 
the child removed into clean, healthful 
quarters, and put under the care of a tidy 
and sensible woman. In fact she adopted 
it, it being motherless. The child made 
a good recovery in the course of time. 
Precaution was taken against the bowing. 



PREVENTIVE MEDICINE 93 

of its legs. All osseous distortions were 
absorbed, and the child grew up into a 
healthy and bright young lady. 

Did I give this child lime in any form? 
Very emphatically I did not. Did I ever 
give it in rickets? Yes, when I was too 
young in the practice to know any better. 
Unless lime-lack, and not malnutrition, is 
the disease, can any sane doctor tell me 
why lime should be given in these cases? 
Even if lime-lack were the disease, can 
any one give a reason why the ingestion 
of lime would do more than temporarily 
alleviate the symptoms f And yet, tons and 
tons of lime have been poured down the 
innocent throats of rachitic children. 
Why has this been done? It has always 
been done responsively to the tissue-feed- 
ing impulse— that sciolistic taint which 
has filtered through the ages and which 
is yet in universal evidence. See the 
force of this inherited fallacy. It is 
capable of overriding reason, strangling 
common sense, and discrediting the re- 
sults of observation. Necessarily there 
has never been a single instance in which 



94 PREYBfrttVB MBmrcms 

U helped a rickety child ia the smallest 
degree. If its fraction is anything bat 
chemical — dependant upon its antacid 
quality— -what is it? What is true of 
time is inescapably true of all other so- 
called "tissue foods/ 9 

About all authorities agree that what- 
ever else we may give a rickety ehild, 
we must give it cod-liver oil. I used to 
give much cod-liver oil in my practice , 
hut I must confess that I never got any* 
thing but harm out of straight cod-liver 
oil. It is only a gross order of indigest- 
ible and disgusting food, that is all. Its 
chemical elements, if isolated, are drugs, 
but so are those of wheat, or any other 
food. As naturally combined, they are 
not drugs. As emulsified, and associated 
with drugs, I believe it to be more or less 
remedial in some conditions. But this 
is not because cod-liver oil is medicinal, 
for it certainly is not. 

The drug treatment for rickets, to be 
rational, must be directed mainly to the 
stomach. This is the citadel of life, and 
unless it functions rightly, no disease d*» 



yendent-*- directly a? iadireetly^upwi 
feulty metabolism, can be cured. Newly 
always* correct hygienic relations* with 
tUfOlul attention to the diet, wiU over- 
come the indigestion. At most, accord* 
jpg to my experience, the patient will 
*equi*e nothing more than a little nu* 
vomica, with, perhaps, some bismuth subr 
^itrate. Unless pickets has progressed 
fiur enough to have seriously affected the 
ribs* a more or less hopeful prognosis 
Stay be rendered. 

In all diathetic and wasting diseases 
(the "iron and cod-liver oil" diseases) 
hygiene, with, perhaps, a dash of the 
"hitter tonics," is our only hope. This 
is true, according to my experience and 
observation, and those have been very 
considerable. I have discussed rachitis 
because its successful management illus- 
trates the fallacy of the tissue-feeding 
potion. A food is a food, and a drug is a 

CAW THIBD 

Anemia* Although my reference to 
ftAemta in th# body of this woark ought to 



96 PREVENTIVE MEDICINE . 

be philosophically sufficient, I feel that I 
would better report a case. The report 
will bring out in detail examples of the 
application of my aphorisms, or more 
properly, axioms. 

In the body of this work, I gave a 
partial list of the causes of anemia. I 
do not believe there is an idiopathic 
anemia. If there is, it has never been 
actually differentiated and set out in re- 
lief. The commonest form of anemia 
has been denominated idiopathic, with 
the qualification that the primary lesion 
is something back of it ! But if there is 
an idiopathic anemia, does the essence of 
it consist in an element lack? If it does, 
can this lack be mechanically, or chemic- 
ally, or mechanico-chemically dissipated? 
Is it conceivable that a lack can be 
primary, and not sequential? What is 
lacknes8 but absence-of , and what is this 
but negation, and what is negation but 
nothing? Now nothing is without relation, 
and shall we attempt to relate a drug to 
the unrelationablet The basis of disease 
is positive and material, and is relatable 



.P.HSVVNT1VB MVDIQINB 97 

only to the positive and material. Shall 
you object that this rules out the psycho- 
logic? It does no such thing. This 
is because all is matter. There is no 
limit to material divisibility, and no de- 
gree of tenuity th$t is not-matter. Not- 
matter is unthinkable, because it ("it" is 
not it) is without relation, and to think is 
to relate. Necessarily then, we think and 
utter in terms of the material. This is 
subtle, but if you will bore down deeply 
enough, it will be as clear as daylight to 
you. This metaphysical phase (really 
nothing is " metaphysical") is somewhat 
exhaustively discussed in my "Immortal- 
ity." 

Prom the foregoing, it ought to be 
plain that there is not, and cannot be, 
any disease, the intrasystemic cause of 
which is either a general or a specific 
lack. Lack of hemoglobin, for instance, 
is always then a disease-effect. Then is 
it not plain to you, doctor, that any at- 
tempt to directly supply this lack is bald 
symptom- whackery? It must be clear to 
you too, that there can be no idiopathic 



98 PREVENTIVE MEDICINE 

anemia, properly speaking. Anemia 
always results proximately from a de- 
rangement of the blood factory. It is 
that form of malnutrition in which the 
endangium fails to elect the iron element. 
That is the true definition of what the 
word "anemia" is made to stand for. 
The word is a misnomer, as generally 
used, for a very large majority of the 
cases we encounter, do not depend upon 
a loss of blood. 

But the patient. She was the usual 
one— a girl of 15. The cause was, of 
course, defective metabolism. The cause 
of this was that physical doubt infallibly 
incident to her sex and her age. Back 
in that biologic arcanum where epochal 
facts are elaborated, a misadjustment had 
occurred. I don't know what it was — 
you don't know what it was. Some ad- 
versely related physical nuance, it may 
have been in the first instance. We can 
explore this cryptic realm, only with 
drugs. Out of uncounted millions of 
experiments, it has developed that cer- 
tain drugs address themselves specifically 



PREVENTIVE MEDICINE 99 

"to this realm. Principal amongst these 
are macrotys, Pulsatilla, viburnum, gos- 
sippium, etc. I prescribed as follows : 

Spec. Macrotys - - - zss 
" Pulsatilla - - gttxv 

Chloroform Water - - |iv 

M. Sig — A teaspoonful 3 or 

4 times a day. 
She was to take this for a week. On 
the next week she was to discontinue 
this and take a permanganate prepara- 
tion. This, which is a proprietary rem- 
edy, contains iron, but is good in spite of 
this fact. Iron, like potash, makes a 
.good chemical back-stop, so to speak ; 
and its easy associability with other 
drugs, makes it pharmacally handy. If 
I were a good pharmacist, I would not 
use this preparation but would make a 
similar one minus the iron. I have found 
through many tests that the manganese 
salts directly conduce to blood-making 
^better than any drug I ever used. Iron, 
itself, does positively no good, and we all 
inow it always does some harm. If iron 



100 PREVENTIVE MEDICINE 

were a remedy in anemia (or anything- 
else,) it would be given straight. Why 
don't the doctors use the pulverized metal, 
or the oxide of iron? Simply because 
they have been amply tested and found to 
be no good. Any good done by any iron 
preparation, is always directly attribut- 
able to the drugs associated with the iron. 
I shall not expand further on this point- 
here, but I ask my brethren to carefully 
study clinical results, and see for them- 
selves whether or not my contention in 
this matter is correct. Remember, that- 
if it could be established that iron ia 
remedial in a particular condition, this 
would not constitute even the fraction of 
an argument in favor of the tissue-feeding 
delusion. 

On the third week my patient was put 
back on the first prescription, except that 
an equal amount of spec, gossippium was 
substituted for the spec, macrotys. On 
the fourth week, the first prescription 
again, and on the fifth week, the second 
prescription, and so on in the same order 
throughout. In connection with thia 



PREVENTIVE MEDICINE 101 

-drug treatment, sea salt baths, massage 
and gentle outdoors exercise were ordered. 
In a little over two months the girl was 
practically well. This has been my line 
of treatment in all similar cases and it 
has been most satisfactory. In perni- 
-cious anemia do the best you can — your 
patient will die anyhow. If the patient 
Tecovers, it was not pernicious anemia; 
at least that seems to be the verdict of 
Authority. My treatment for chlorosis 
has been about the same as that for 
anemia, except that I have always run in 
.a gentle hepatic stimulant. 

CA8K FOURTH 

Pneumonia. In the dominant school of 
medicine, this is regarded as an extremely 
•dangerous disease. Osier, who is prob- 
ably the most authoritative writer in the 
school, treats the subject in a very pes- 
simistic spirit. He intimates that, so far 
from becoming less fatal under modern 
management, the disease is growing more 
fatal. A death rate of from 20 to 40 per 
<3ent. is accepted as inevitable. In the 



102 PREVENTIVE MEDICINE 

liberal schools, so called/ the death rate* 
is fixed at 5 per cent. I have made a 
careful, comparative study of this ques- 
tion, with the resulting conviction that 
under rational treatment, the fatality or 
pneumonia should not exceed 5 to 10 per 
cent. I believe that — taking the disease 
as it comes — we should not have an 
average death rate of more than 7£ per 
cent. I believe the increased death rate- 
under "regular" management, depends 
upon hypermodication — the patient is not* 
permitted to recover, It is comparatively 
rare for an old school physician to give 
his pneumonia patient less than 8 or 10 
different drugs during his sickness. Pick 
up any old school journal and read the 
reports of cases of this disease and you 
will see my statement verified. They 
not only give too many powerful drugs,, 
but give them too heroically. The usual 
course of old school treatment for pneu- 
monia would put a healthy person to bed.. 
If thi&is true, and it is true that what wilV 
make a well man sick will make a sick man> 
ticker, is it not plain that the ill success^ 



PREVENTIVE MEDICINE 103 

of our old school brethren in this disease 
is the result of hypermedication? 

It has happened that my experience 
with this disease has been peculiarly 
fortunate all through. This fact is so 
emphatic that it has half convinced me 
that there are fortuitous combinations of 
conditions which we have to call luck. 
But making the most generous allowance 
for that doubtful fact, it seems to me that 
my method should count for something, 
in view of the fact that I have never lost 
but one case of pneumonia. This seems 
incredible, and I understand most thor- 
oughly how certainly the statement will 
expose me to the charge of mendacious 
boasting. But the statement is true and 
I can't help it. 

My treatment for pneumonia comes 
dangerously near to being dangerously 
routine. By the way, are not all stand- 
by treatments nearly that? Is not 
the treatment for periodic malaria toler- 
ably routine? Is not the same true 
of the treatment of syphilis? And there 
are others. But here is my pneumonia 



104 PREVENTIVE MEDICINE 

treatment : To a glass i full of water, t 
add 6 to 8 drops of spec, veratrum, and 
4 to G drops of spec, bryonia. The pa- 
tient is to take a teaspoonful of this every 
hour while awake. His sleep is never to 
be disturbed. I believe this combination 
to be specific to the primary lesion of 
pneumonia. I believe this lesion to 1t>e 
one, bearing the same relation to the 
pathologic tree, as the tap-root of any 
tree does to the rest of the tree. 1 almost 
never waste any time in trying to lop ofiT 
any of the branches of this tree. Why 
should I attempt to do a thing I, and 
everybody else, know can not be done? 
To make such attempts, is to diminish 
the patient's chance of recovery by wast- 
ing his time and vitality. The disease- 
pbtentiaiity inheres in its t&p-root, and 
tHb suggestion of the very commonest 
sShse is to abolish that ta^-rodt. Th£re- 
folte I have always hewed to the Causal 
line from start to finish, allowing almost 
nothing to divert me from ftiy specific 
purpose. If a belladonna syniptoih 
coines up, unless it is so madly pro- 



PREVENTIVE MEDICINE JOS 

nounced as to amouht to a usurpation of 
^lie entire pathologic situation, I let it go. 
The same is true of my method with 
reference to any other seeming drug-call, 
'there are a great many twigs which , in 
Appearance, are common to about all 
pathologic trees, as there are twigs which 
in appearance are common in various 
Forest trees. But these twigs are not 
identical unless the tap-toots are, and we 
know they are not. A beech tree will 
not throw out a maple twig, and a pneu- 
monia tree will not throw out a scarlatina 
twig. The typhoid "condition," common 
to many diseases, is simply an expression 
of vital exhaustion, common to all dis- 
eases. It carries Villi it ho peculiarity 
which is specific with reference to a par- 
ticular disease. The surface identifying 
symptoms certainty do this, but as yet, 
Ve are not capable of differentiating 
their peculiarities. Otherwise disease is 
hot self-consistent. 1 belipve then, that 
scarcely anything should deflect us from 
the primary purpose of ablating the pri- 
mary lesion . If veratrum arid bryonia are 



106 PREVENTIVE MEDICINE 

specific to this lesion, and no other known 
drug is thus specific, what excuse is there 
for the employment of other drugs? 
There is one thing certain, and that is 
that whether my drug treatment for pneu- 
monia does my patients any good or not, 
it does them no harm, either positive or 
negative. The quantity is too small to 
do any positive harm, and since there is 
no other even putative specific for the 
disease, it does them no negative harm. 
This is a great thing to know, for it en- 
ables you to look both your patient, and 
your own conscience squarely in the face 
all through the term of illness. It will 
have been (correctly) inferred that I 
scarcely ever give my pneumonia patient 
any other medicine than the veratrum 
and bryonia. In relation to modern 
eclecticism, and homeopathy, and measur- 
ably to "allopathy," this is heterodox, 
for it does not conform to the dictum — 
"Meet conditions as they rise." Now, 
in fact, does anybody do this in those 
diseases for which they have a stand-by 
treatment? In scores jof. ^typical cases 



PREVENTIVE MEDICINE 107 

and anomalous conditions, I try to meet 
conditions as they rise, and I assure you 
I have plenty of that kind of experience. 
In conjunction with this drug treat- 
ment, I rigidly enforce hygienic observ- 
ances. It represents fully one-fourth of 
our aggressive equipment, you will re- 
member. A temperature that is agree- 
able to the patient; ample ventilation 
without direct drafts ; a suitable and 
sufficiently scant liquid diet; quietude 
and social serenity ; these are the required 
conditions. There must be no company, 
and no noise of any kind, not even the 
rustle of a newspaper, and the patient is 
to be talked to as little as possible. Over 
the chest is laid a greased rag on which 
has been sprinkled enough of the com- 
pound powder of lobelia and capsicum to 
cover the surface. This does a little 
counter irritating, besides acting medi- 
cinally through absorption, and it is free 
from the monstrous objection of weight. 
Right here I must run in my protest 
against the use .of,.slopj)y and weighty 
applications to the thorax. The mush 



108 PREVENTIVE MEDICINE 

jacket will serve as a type of these devil- 
ish abominations. It will never weigh 
less than a pound, generally twice that. 
The patient breathes 20 to 30 times a 
minute. Estimating as conservatively 
as possible, it will force the respiratory 
muscles to lift 20 pounds per minute ; i. 
e., 1200 pounds per hour ; i. e., nearly 15 
tons in every 24 hours ! Remembering 
that every lift subtracts that much from 
the vital reserve, and remembering that 
the patient's recovery must depend solely 
upon the quantity of vitality he possesses, 
and remembering that a large majority 
of physicians put this drain upon their 
pneumonia patients in addition to the 
life-sapping effects of hypermedication, 
is it astonishing that the mortality of 
this disease should be so great? Of 
course the same objections that apply to 
the mush jacket, apply to flax seed, and 
other poultices, and to that invention of 
the devil, the ice pack. To make the 
use of these abominations justifiable, see 
what an enormous therapeutic value 
they would have to possess. Can any 



PREVENTIVE MEDICINE JQC) 

doctor liviug give one philosophic or 
common-seuse or practical reason why 
these wet wads should do any therapeutic 
good? It is not conceivable from any 
rational standpoint that they can possi- 
bly do anything but harm. 

Here, too, I must protest against the 
use of drug antipyretics. They are given 
under the assumption that the elevated 
temperature does more harm than the 
antipyretic does. It is held that this 
high temperature causes a parenchyma- 
tous degeneration of the muscles and 
other tissues. How they discovered that 
it is the high temperature and not its 
cause, that brings on this degeneration, 
is a mordant puzzle. And how they 
know that this degeneration is worse for 
the patient than is the devitalization at- 
tending the use of antipyretics, is another 
tough puzzle. We do not know that un- 
der the conditions the high temperature 
does harm ; we do know that antipyretics 
do harm, great harm. In view of these 
facts are we morally justified in the use of 
antipyretics? In view of the fact that 



HO PREVENTIVE MEDICINE 

antipyretics have never been knoivn to do 
good, are we therapeutically justified in 
their use? In view of the facts that it 
has never been proved that drug antipy- 
retics do any good, and it is known by 
all intelligent doctors that (because they 
are all of them cardiac depressants) they 
do great harm, is not the use of them 
criminal? Here is the truth about the 
use of antipyretics in a nutshell : To the 
extent that they reduce the temperature, 
they reduce the patient. 1 abandoned the 
use of drug antipyretics 15 years ago, 
and very great has been my reward, both 
clinically and in the satisfaction of hav- 
ing a clear conscience. In this case 
which I am so tediously reporting, when 
ever the temperature got uncomfortably 
high, I had the patient sponged off with 
a tepid solution of soda bicarb. Enough 
of the soda is put into the water to make 
it slightly slippery. I use this in all my 
fever cases. It is grateful and soothing, 
and instead of being vitally wasteful, it 
is vitally conservative. 
The engorgement of the lungs puts ex- 



PREVENTIVE MEDICINE HI 

tra labor on the heart in pneumonia. It 
has a hard tug of it, but is this a disease f 
We know it is not — it is a disease-effect. 
Shall we whip this over-worked heart, 
remembering that to do this is to neglect 
that organ (the lungs) , which to neglect, 
is to increase the heart trouble? Can 
any heart treatment better that organ's 
condition so long as the cause of its con- 
dition persists? We do certainly know it 
can not. What shameful folly, then, it 
is to crowd strychnia, degitalis, etc., into 
our pneumonia patients. 

When the patient's vital possibility is 
nearly exhausted and the case begins to 
look doubtful, shall we resort to stimu- 
lants? I know how perfectly natural it 
is for us to do this, but is it for any other 
reason than that this has always been the 
custom? The origin of the use of stimu- 
lants in low conditions must have de- 
pended upon the fact that they exhilarate 
for a time, giving the treacherous ap- 
pearance of immediate improvement. 
Can the most brilliant theoretic thera- 
peutist give one legitimate reason why a 



U2 PREVENTIVE MEDICINE 

stimulant should ever be used either by % 
sick or well person? If a stimulant hacj 
the power of deflecting a morbid tren<^ f 
or if it imported any vitality into the sys- 
tem, then its employment would be jus- 
tified. But it does neither of these— it 
does nothing commendable. It is noth- 
ing but a whip, and the whip idea holds 
no defensible, much less, righteous sig- 
nificance. I have said in another place 
that we have to whip a disease out of the 
system. That merely has reference to 
the opposition of forces involved in shock, 
and does not affect the sinisterism that 
inheres in the whip idea. We — those of 
us who are mean enough — whip a tired 
horse. Does it do the horse any good, 
and doesn't it do us harm? 

We hear of tiding one over a crisis by 
the use of a stimulant. This is, of course, 
a pure assumption. What evidence is 
there that stimulants may tide a very 
sick patient over a crisis? Simply none. 
What a weakening travesty it is — two or 
three doctors around a patient in extremis, 
shooting into him brandy, nitro-glycerine, 



PREVENTIVE MEDICINE H3 

etc., when they know these drugs carry 
no vitality into the system, and do know 
that they subtract vitality from the sys- 
tem, and above all, do know that the life 
of their patient must depend upon a suf- 
ficiency of this same vitality. For the 
good Lord's sake, doctor, or rather for 
your patient's sake, the next time you 
want to tide a patient over a crisis, give 
him frequent sups of hot milk. If any- 
thing on earth will add to his waning 
vitality this will. If he die in spite of 
this, you will have a clean conscience at 
least. 

Of course every reader will vote my po- 
sition on the use of stimulants, fanatical- 
ly extreme. Although I might give a 
score of reasons why stimulants do harm, 
and the reader cannot give one reason 
why they should do good to a sick person, 
his mind will not be changed. The force 
of an early impression, with its conse- 
quent habit of thought along a particular 
line, is something astonishing. I never 
see the new moon first over my left shoul- 
der without a start, — and I am over 70 

8 



114 PREVENTIVE MEDICINE 

years old ! It almost amounts to a self- 
contradiction to refrain from the use of 
stimulants in collapsed conditions, but 
this impulsion is emotional, not intellec- 
tual. It is the result of feeling and 
habit, not rational analysis. If it could 
only be remembered that a stimulant 
does not convey into the system either 
warmth or vitality, and that it does ab- 
stract these from the system ; and if it 
could be further remembered that hot 
milk does carry both warmth and vitality 
into the organism, would it make any 
difference? Almost unexceptionally, no 
—fixed conservatism is more than a 
match for common sense. 

It would not be treating stimulants 
fairly, not to admit that there are three 
situations justifying their use. First, as a 
counter-irritant ; second, if you are going 
out into a cold storm ; third, if you are 
going to be exposed to a contagious dis- 
ease. In the two latter cases stimulants 
do good by putting the system into an 
eliminative condition. A hot cup of 
coffee would do just as well ; indeed, bet- 



PREVENTIVE MEDICINE H5 

?ter, but it is not always readily accessi- 
ble. You see, I gladly give the devil his 
•due. The only hope for a patient at the 
point of death lies in an increase of vital- 
ity, not in diminishing the remnant of it 
'which provident Nature is cautiously 
paying out. The stimulant draws on the 
*vital sum on its own account, thus lessen- 
ing the amount to be rallyingly applied. 
Nature judiciously applies the vitality in 
her reparative effort, up to the last spark, 
mrhich goes out coincidently with the last 
^breath. Not a diversion of this vitality 
from center to circumference will save 
the patient— only an increase of it will do 
*hat. If anything will increase the vital- 
ity, you do certainly realize that the hot 
milk will do it. The stimulating idea is 
fundamentally and essentially fallacious, 
and it has been responsible for an inesti- 
mable amount of harm. 

In the treatment of pneumonia, as in 
the treatment of all other diseases, my 
leading purpose, from first to last, is to 
conserve the patient's vital capacity. I 
know this is right, and so do you, doctor. 



116 PREVENTIVE MEDICINE 

Having said so much about the importance- 
of husbanding the patient's vitality, a brief 
discussion of this vitality question will not 
be out of place. Proximately considered, 
vitality is an energy, generated out of the- 
co-ordination of organic functions. Tha 
impairment of a single function then, sub- 
tracts some (at the time) from the organ- 
ism's vital capital. From this, it is seen 
that the quantity of vitality in stock, so- 
to speak, varies with changing vicissi- 
tudes. Besides that it varies in different 
persons. Fixing the maximum vital 
possibility at 100, as represented by the 
heavy-weight athlete, it will be seen that 
only a few enjoy its possession. But as 
the healthy heavy-weight athlete's vital 
sum is to him, so the healthy ninety- 
pound man's vital sum is to him, and the 
smaller man's life-promise is as great as 
is that of the larger man. Therefore 
each person's vital maximum, if it is but 
25, is as vaulable as the large man's 100. 
That is why B, with a vital maximum of 
25, is as hard to kill by disease, as is A 
with his vital maximum of 100. One is 



PREVENTIVE MEDICINE H7 

lelow par to the extent that his vital 
sum varies from his vital maximum. 
The vital maximum of those born with a 
•disease taint, or weak constitution, is a 
fictitious one, and does not bear a normal 
relation to his life-promise. This fact is 
always taken account of by the prudent 
And far-sighted physician. Each healthy 
person accumulates a reserve stock of 
vitality which he measurably expends in 
liis daily vocation. Beyond this, how- 
ever, provident Nature endows him with 
an emergency fund against accident and 
sickness. That is, Nature endows him 
with a capacity to accumulate this fund. 
When one gets sick, his system draws on 
this reserve till it is exhausted (provided 
his sickness is not mild or of short dura- 
tion) when it begins to consume his cur- 
rent supply, which now grows rapidly 
less. Thus one's sum of vitality may be 
reduced to one-fifthieth of his vital maxi- 
mum, so that he will be 50 times as 
easily killed as he would be in perfect 
health. Remembering that the wrong 
-drug makes unqualifiedly for death, and 



118 PREVENTIVE MEDICINE 

that too much of even the right drug does; 
this, and remembering that the probabil- 
ity of your selecting the right drug is, in 
many cases, as 1 is to 100, is not the* 
momentous importance of cautious med- 
ication made manifest? This enables us* 
to realize what a magnificent and over- 
topping virtue small dosage is. I am 
thoroughly convinced that, so far as the* 
drug feature goes, the usual physician 
harms 100 of his patients for every one- 
that he helps, and yet I am a firm be- 
liever in drugs and dtictors. 

When the disease has exhausted its- 
series of morbid phenomena, then (if the* 
patient has lived to this point) the* 
functions of the organism will have fallen 
into normal line, and the manufacturing 
of vitality, which had been nearly sus- 
pended, will take on a fresh impulse, and 
the patient will proceed with more or 
less rapidity to recovery. The justifica- 
tion of cautious medication depends* 
wholly upon the fact that what will make 
a well man sick, will make a sick man 
dicker. 



PREVENTIVE MEDICINE H9 

FIFTH CASK 

Malaria. It is scarcely truer that we 
have the poor with us always, than it is 
that we always have malaria with us. 
Skeeters or no skeeters, malaria is always 
more or less in evidence. It is a compre- 
hensive and polyglot disease. Even with- 
in its special preserves, it is very diverse 
in its expressions. There are a dozen 
varieties of the periodic phase of it, 
and as many more of the non-periodic as- 
pect. Yellow fever is malaria gone mad. 
Mountain fever is a sort of high-altitude 
malaria. I have felt that La Grippe has 
a malarial back-ground. I know of no 
disease more manifold in its manifesta- 
tions than malaria . It is , therefore , worth 
serious consideration. 

James White came to me with the com- 
plaint that he was "no good." Pelt 
achey, languid, sleepy and "sort o' all- 
round knocked out." In this section, 
this is a very common form of malaria. 
Of course I gave him the G-B — which 
does not mean the "Grand Bounce." 
Some of my medical confreres, with 



120 PREVENTIVE MEDICINE 

whom it has become a stand-by, thus 
abreviated it. What is meant is, Gelse- 
mium and Bryonia. This is my remedy 
in all non-periodic, and some periodic, 
forms of malaria. It is the remedy for 
children or delicate women in all forms 
of the disease. It bears the relation to 
malaria that the ocratrum and bryonia 
combination does to pneumonia. De- 
prived of it, I should be helplessly at sea 
with reference to malaria. With it, I 
approach all these cases confidently. 

To an average glass, filled nearly full 
of water, I add 20 drops of specific gelse- 
mium, and 5 drops of specific bryonia. 
Of this, the adult patient is to take a tea- 
spoonful every hour. The medicine is to 
be kept covered, and in a cool place. 
This fact applies, of course, to all these 
watery prescriptions. My patient was all 
right in two days, of course. If I had 
given him quinine, there would have 
been not one chance in ten of it doing 
him any good, and there would have 
been ten chances to one of it doing him 
plenty of harm. In periodic malaria > 



PREVENTIVE MEDICINE 121 

quinine is the remedy. It should never 
be given when there is fever. It should 
never be given to children, nor to feeble 
adults . It is astonishing how little quinine 
we need in our practice when the G-B is at 
our command. I do not use half an ounce 
of it in a year. Yet there are cases which 
only quinine, or quinine and the G-B to- 
gether, will cure. These are persistent 
intermittents, in naturally robust people. 
Preceded with a good physic, with calo- 
mel or podophyllum 30 grains of quinine 
given within 48 hours, ought to break up 
almost any case of intermittent fever. 
But in this *part of the country, such 
cases have become comparatively rare. 
The G-B will suffice in nine-tenths of 
all the malarial cases we are called upon 
to treat. In malarial fever, the G-B is 
the remedy par excellence. It frequently 
converts the fever into an intermittent, 
when a little quinine comes in all right. 
This G-B has served me better in La 
Grippe too, than anything else I have 
ever tried. I give it the same as for 
malaria, always instructing the patient 



122 PREVENTIVE MEDICINE 

nlso to take frequent sips of hot water to 
which has been added a pinch of salt. 
After trying various "grip remedies," I 
was forced to come back to this method. 
It will cure two-thirds of your cases with- 
in 48 hours ; frequently within 12 or 15 
hours. Quinine is strongly contra-indi- 
cated in influenza. It not only fails to 
cure, but actually fixes the disease in the 
system, and prolongs it indefinitely. In 
grip fight shy of quinine. 

Note that this treatment is simple, di- 
rect and conservative. It is not in any 
sense risky — it is mfe both positively and 
negatively. It is clearly and cleanly 
within the precincts of the three funda- 
mental axioms, and it gives results — the 
kind you want. 

MISCELLANEOUS 

Typhoid Fever. In this disease, as in 
all others, a knowledge and observance 
of the don'ts is of vastly more importance 
than is that of the do's. The principal 
thing to do j is to do not certain things. 
Do not physic a typhoid patient — it 



PREVENTIVE MEDICINE 123 

will only further irritate Peyer's patches. 
Move the bowels by means of injections, 
if they must be moved. A proper flush- 
ing of the colon with a solution of muri- 
ate of hydrastia, occasionally, is the thing. 
Five grains of the hydras, mur. to one 
quart of soft water is about right. This 
is the greatest depurant and antiseptic 
there is. 

Don't give your typhoid patient anti- 
pyretics, nor stimulants, nor analgesics, 
nor diaphoretics, nor "heart tonics," nor 
concentrated food. Reduce temperature 
with spongings of tepid soda water. 
Don't employ full baths, and especially 
avoid cold baths. Don't try to whip up 
the appetite, and don't press foods -»u the 
sick one. There may be calls for some 
of the 'polychrests' specially including 
baptisia, echinacea, etc. Nature must be 
given full swing, and therefore the main 
thing in this disease is good nursing. 

Colds. A cold in its incipiency, can, 
in nine out of ten cases, be aborted. This 
is an important thing to know, when we 
Temember how many different forms of 



124 PREVENTIVE MEDICINE 

sickness originate in a ^bad cold." The 
very best cold abortant is aconite and bel- 
ladonna in minute and frequent doses. 
Thus, to a glass nearly full of water, add 
4 or 5 drops each of specific aconite and 
specific belladonna. The patient is to 
take a teaspoonful of this every 15 min- 
utes till 3 or 4 doses shall have been 
taken, then every half hour till 3 or 4 
doses shall have been taken, and from 
that on, every hour. In connection with 
this, frequent inhalations of menthol is a 
good thing, as also, frequent sups of hot 
water. Exactly the same method, except 
that you substitute the G-B for the aco- 
nite and belladonna, is the abortive and 
continuous treatment of la grippe. A hot 
foot bath, with a hot vinegar stew, or hot 
lemonade, etc., often does evident good. 
In that stretchy and achey form of cold 
contracted from exposure to dampness, or 
particularly from remaining too long in a 
fireless room, the alcoholic vapor bath, or 
hot sitz bath, is very efficient. Of course 
the employment of this, does not preclude 
the use of the other measures named- 



PREVENTIVE MEDICINE 125 

Sometimes a big dose of quinine will 
more or less abort a cold, but because of 
Us harshness and ill effects, I never use 
it. 

I shall report no more cases, but it may 
not be amiss for me to give here a few of 
my pet prescriptions. They are not sin- 
gle-drug remedies, but they are trust- 
worthy, and no single drug can be more 
than that. These stand-bys of mine are, 
most of them, old and tried friends of 
many eclectic physicians, but they will 
be new to nearly any old school brother 
who may happen to read this little book. 

As to Tonsilitis. Would about all 
cases recover without treatment? I 
think they would. Does the right treat- 
ment hasten the cure? I am thoroughly 
convinced that it does. Is there a known 
right treatment? I do surely think there 
is. I think this because I have instituted 
tests and comparisons in this disease, 
with results that were incontestably in 
favor of a particular treatment. Here is 
that particular treatment : To a glass 
f full of water, add 4 or 5 drops of spe- 



126 PREVENTIVE MEDICINE 

cific aconite, and the same quantity of 
specific belladonna. If the more external 
glands are involved, add also 5 or 6 drops 
of specific Phytolacca. The patient is to 
take a teaspoonful of this every hour. If 
putrid conditions develop, give specific 
baptisia or echinacea in alternation with 
the remedy named. Of the baptisia, give 
one-fifth to one-third of a drop, and of 
the echinacea, from 5 to 15 drops. A 
gargle is of doubtful utility. If it could 
be kept in contact with the inflamed sur- 
face all the time, it might be of some ser- 
vice. This, of course, cannot be. I do 
not think that external applications do 
much, if any, good in tonsilitis. Tonsilar 
ulcers will get well much more quickly if 
cauterized, though they will get well in a 
few days without it. Cauterize with ni- 
tric acid, using the pine stick porte 
caustique. This is safe, because there is 
no salt to break off and drop down the 
throat. 

Rheumatism. There is no specific for 
any form of this disease. The most usu- 
ally indicated drugs are macroty, bryonia, 



PREVENTIVE MEDICINE 127 

Phytolacca, and salicyllate of soda. In- 
flammatory rheumatism is one of the 
most trying maladies we have to deal 
with. In this cruel disease, the forces of 
humanity and pity drive us to the use of 
anodynes, nolens voUns. Whatever else 
we do, we have to assuage the victim's 
Bufferings. His need of relief is so atro- 
ciously urgent that we could not adhere 
to a strictly causal treatment, even if we 
possessed such a treatment. What I have 
said gives me an excuse for exploiting 
my pet anodyne. Nothing less than an 
opiate will do in in inflammatory rheu- 
matism, or any other extremely painful 
condition. But the disagreeable after- 
effects of any form of opium constitute a 
great objection to its use. To a great 
extent my anodyne, although it contains 
both opium and morphine, overcomes 
this objection. Why it should do so, I 
do not know. This ideal anodyne con- 
sists of a combination of morphine and 
our (the eclectic) diaphoretic powder. 
The maximum dose for an adult (not 
addicted to opium or morphine) is, mor- 



128 PREVENTIVE MEDICINE 

phine gr. ± ; diaphoretic powder, gr. 5 to 
8. The obtunding effect lasts about 12 
hours. In only a small proportion of 
cases will this be followed with headache 
or nausea. I have not used my hypo- 
dermic syringe for 12 years. It is proper 
for me to say here that I believe in eu- 
thanasia, and that in doubtlessly doomed 
cases, I push pain-easers to the limit. 

Pleurisy. In this disease I usually de- 
pend upon bryonia, or bryonia and ar- 
nica combined. But if I am called to a 
severely acute case, which is so urgent as 
to demand immediate relief, I strip the 
patient, have him seated with his feet in 
a bucket of hot water, and with a blanket 
thrown around him. Then, in connec- 
tion with hot teas, I give him, every few 
minutes, a teaspoonful of the old sudor- 
ific tincture. Soon the patient will be in 
a profuse perspiration, and coincidently 
with this, his pleuritis will disappear. 
This treatment is heroic and old fash- 
ioned, but it is thoroughly trustworthy. 

Tetanus. Unless proper precautions 
are taken, a punctured or lacerated wound 



PREVENTIVE MEDICINE 129 

holds a very dangerous possibility — the 
possibility of tetanus. It is my convic- 
tion that tetanus can always be prevented 
if the following method be adhered to : 
First, thoroughly clean the wound, using 
simply warm water. Then treat it freely 
with spts. of turpentine. The turpen- 
tine neutralizes the toxin upon which 
tetanus depends. I suppose that within 
the last 40 years, I have treated a hun- 
dred of such wounds, and not a sign of 
lockjaw ever followed. This was also the 
experience of Dr. A. E. West, who had 
been in the practice 50 years, and who 
acquainted me with the treatment. I 
have treated 8 or 10 cases of strongly 
threatened tetanus following wounds 
(stiffened masseter muscles, nervous 
twitching, etc.) as follows : I freshened 
the wound and saturated it with turpen- 
tine. Reapplied the turpentine two or 
three times within the first 24 hours, then 
much less frequently. This is the same 
as the preventive treatment in fresh 
wounds. Several times within 24 hours, 
I had the spine rubbed several minutes 



130 PREVtrtfTlYE MEDW1NE 

with strong, hot mustard water. Inter- 
nally I gave a combination of macrotys 
and gelsemium. A dram of specific ma- 
crotys and 20 drops of specific gelsem- 
ium are added to 6 oz. of water. A tea- 
spoonful of this every three hours is the 
dose for an adult. This treatment has 
always been sufficient; at least these 
patients have always recovered. I never 
treated but two cases of outright trau- 
matic tetanus. Both of these cases were 
typical ones, characterized by locked 
jaws, tetanic convulsious, opisthotonos, 
etc. I employed exactly the same treat- 
ment I have named, and both patients 
recovered. This is very extraordinary. 
Whether the treatment cured them, or 
whether they got well just anyhow, I 
don't pretent to know, but I do know that 
if I am ever called on to treat another 
case of tetanus, I shall employ this same 
course of treatment. 

THERAPEUTIC CBRTI TUDES 

Is it not remarkable that after all the 
chiliads of medical travail, we can count 
the therapeutic certitudes on the fingers 



PREVENTIVE MEDICINE 131 

of one hand? It is at once a fine com- 
mentary on the complex difficulty of drug 
empiricism, and on the tireless persist- 
ence of the acquiring instinct in man. 
Here are the certitudes : Iodide of potas- 
sium in secondary or tertiary syphilis ; 
quinine in periodic malaria; the anaes- 
thetics, chloroform and ether ; Phytolacca 
in mammary inflammation, and sulphate 
of magnesia with bismuth for sporadic 
dysentery. 

Compound stillengia liniment comes 
very nearly to being a certitude in com- 
mon croup. It is generally only neces- 
sary to rub a little of it on the upper lip 
more or less frequently so that the child 
-can inhale its fumes. I also direct the 
nurse to rub a little over the larynx. In 
very urgent cases, doses of one to three 
drops (according to age) can be given 
internally. Give it on a little sugar. I 
use it also in membranous croup, at the 
same time giving the child aconite and 
jaborandi internally. This comp. still, 
liniment will rarely disappoint in croup 
or any tight and stuffy conditions. 



132 PREVENTIVE MEDICINE 

There are, perhaps, twenty semi-certi- 
tudes. These are included in the modern 
eclectic "specifics," in some of the homoe- 
pathic 'polychrests,' in two or three 
physio-medical drugs, and in a number of 
old-school preparations. It is the mighty 
mission of Medicine to increase the num- 
ber of certitudes till disease shall lose its> 
terrors, and millennial sunlight shall 
warm and gladden the ways of man. 

This finishes my little book. It is only 
just to various honest and capable manu- 
facturing pharmacists to say here that it 
has not been my intention to treat them 
invidiously. I have mentioned Lloyd V 
specialties because I know them to be ab- 
solutely trustworthy. I am convinced 
that the preparations of at least a dozen 
other pharmacal manufacturers are per- 
fectly honest and very reliable drugs. 
In the interest of therapeutic preci- 
sion and definite ness, I can conscientious- 
ly advise those who do not get satisfaction 
out of the galenicals, to use the alkaloids. 
They are all right. This is in almost na 
sense a work on practice. It is mainly\ 



PREVENTIVE MEDICINE 133 

Intended to be an exposition of Medical 
errors and abuses — an epitome of don'ts, 
with the incidental inclusion of a few 
'do's. Such as it is, it is respectfully 
Jianded over to my brother doctors. 



APPENDIX 



"Cooperisms" — Aphorisms — Epigrams 



Dreams are broken shadows of the 
mind. 
Death pi's us and Nature redistributes 

118. 

The cyclone is a clonic meteorlogical 
spasm. 

Color-blindness is a prime element of 
genuine philanthropy. 

Grip always jumps spraddled. 

In testing antitoxin don't confuse 
diphtheria with diph theory. 

There is hope for the physician who 
will admit he commits malpractice every 
day of his life. 

Life is fiction and friction. 

Life is an evolutionary sentence. Days 
are its commas; weeks, its semicolons; 
months, its colons ; years, its exclamation 
points and death is at once its period and 
interrogation point. 

135 



136 PREVENTIVE MEDICINE 

"It never rains but it pours" is some- 
times true : It never pours but it rains, is 
always true. —Let— 

The sweetest palindrome : No evil live 
on. 

Phthisis wears gum shoes. 

The true doctor shoots with a rifle — 
seldom with a shot-gun. 

If you don't capture the head of a tape- 
worm, your labor is lost. The same is 
true of all disease. 

I would rather be spanked by a giant 
than coddled by a pigmy. 

At least she illustrates a moral phase — 
the ballet girl who conscientiously kicks 
bits, of lubric satisfaction into bald-headed 
concupiscence. 

An acorn is bigger than a toe-cora, but 
it doesn't hurt so bad. 

Does prenatal determination amount to 
much if the prospective mother is a New 
Woman? 

The caliber of a bore does not always 
depend on the size of a hole. 

A woman's stomach reaches from the 
top of her sternum down to her os pubis. 



PREVENTIVE MEDICINE, J37 

A persimmon is your true antiexpan- 
sionist. 

• The sublime : The ridiculous :: Genius : 
Mediocrity. 

The homeopaths are the only people 
who get even with the cimex lectualaris. 

Whatever difference there is between a 
bum and a bomb is in favor of the latter* 

Pity the mortal who can laugh but 
cannot smile. 

I'd rather train a mis* 
In tho proper, way to kiss, % 
Than barely miss a train . , . 

After hurrying through the rain. 
A grain of wisdom is better than an 
ounce of gold, but it won't pay your rent. 
The essence, of the alas-ness of disap- 
pointed love, is sweet-bitterness. 

Do not confound bottomness with top- 
ness in your moments of introspection . 

Warts and corns are blood relations, 
but they don't associate. . 

Yum and mum rhyme nearly as well in 
significance as they do in sound. 

The difference between trophic cancer 
and tropic cancer may be several million 
miles. 



138 PXEV&ITIVE UBBW1NB 

The axis-cylinder of "Ah there," is 
vaudeville lubricity. 

The legitimate healer is seldom "well 
heeled." 

Beef tea is merely urine with a feather 
in its cap. 

A stich in time may keep it from rip- 
ping farther, but you will grow old all 
the same. 

The word "clap-trap" does not mean the 
same to all men. 

Enough hate will precipitate its natural 
solvent, love. 

It is sad, but it is a fact that the butt 
end of a goat has never been differenti- 
ated. 

It does not make much difference to a 
tramp which side of his bread is buttered. 

"A soft answer turneth away wrath." 
It is equally true that wrath turneth 
away a soft answer. 

If it is true that the best guesser is the 
best doctor, it is because the best doctor 
is the best guesser. 

There is not much choice between a 
pain an inch long and an ache a footlong. 



PREVENTIVE, MEDICINE 139 

What is the difference between the 
flame of a fire and the fire of a flame? 

The difference between a collar button 
at large, and "damn it !" is very small. 

To cry is to laugh backward. 

You can't tell what some people con- 
sist of the most— conceit, deceit, or just 
seat. 

The more sense a man hasn't the more 
he doesn't want. 

It is true that one extreme follows 
another, but is exactly as true that one 
extreme leads another. 

The astuteness of an ass is equal to the 
square root of the square of his assness. 

"Jimmy," the name of a burglar's tool f 
is not a nick-name. 

The boy lives in earnest for fmu 

The heavy doser's motto: You can't 
drive a spike with a tack-hammer. 

The very things we like the best 
Are just the things we can't digest. 

Better be rudely healthy than "pale 
and interesting." 



140 PnEVEZ TIVB MEDICINE 

Tooth-ache is only another phase of the 
thrill of a love kiss . 

According to authority, if you cure a 
casft of cancer it wasn't cancer. 

Every man being his own criterion, it 
is always the other doctor who hypermed- 
icates.. 

Mental phymosis cannot be cured by 
circumcision. 

Podophyllin won't reach a constipated 
pocket-book. 

If you subtract the ass from a smart 
Aleck, what have you left? 

Diagnosis is the trigger of prognosis. 

The pocket-book is the clitoris of ac- 
quisitiveness. 

The butt end of a disease is not always 
in the butt end of the patient. 

Biontic evolution is condensed phyletic 
evolution, and don't you forget it. 

To antiphlogisticate is to fight Nature; 

To stimulate is to borrow from a bank- 
rupt future* 

The anodyne cheats the patient and 
blindfolds the doctor. . 

Direct tissue-food is direct myth-food. 



PREVENTIVE MEDICINE 141 

Every stomach is its own best purveyor. 
Heredity is the bole of being. 
That the longest pole always knocks 
the persimmon. 
Is just as true as that Time takes his 
toll ; 
But give us a saw, or a song, or a hymn 
on 
The readiest means of procuring. the 
pole. 
The degree to which a drug antipyretic 
reduces the temperature, is exactly the 
degree to which it reduces the patient 
Beauty is the nap of health. 
Rational empiricism is the condition 
precedent to rational clinicism. 

The physician's clinical success is in- 
versely as the square of his faith in heroic 
medication. 

We have now (1905) a president that 
does things. No one would be much sur- 
prised if he should at any time lift the 
lid of hell and jerk the devil out by the 
horns. 

The motif of a collar button is seques- 
tered hell-ben tness. 

Most booms finally take on an erang. 



142 ntBVEirrtTE medicos 

The critic is he who can't do it him- 
self bat can tell you how to do it. 

The appendix is the surgical center of 
gravity. 

The truest egoist is the truest altruist. 

Gelsemium is Bryonia's right bower. 

Belladonna is aconite's left bower. 

Specific medication is specific sanity. 

Although we must all die, life is the 
rule, and death the exception — with the 
individual. 

There is no direct drug tonic. 

He who serves others best, serves him- 
self best. 

Veratrum and Bryonia — Pneumonia 
"knock-out drops." 

Podophyllin is ambidextrous. 

Digitallis is a sneak and assassin. 

The coal-tar series is a funeral proces- 
sion. 

Medical iron is a superstition. 

A liniment is just -a liniment. 

A poultice "draws" on the imagination 
of the credulous. 

Strychnia is purely a stimulant. 

Don't whip the struggling heart in. 



PHEiriBimvti uEDict&t 143 

pneumonia — whip the cause of its strug- 
gles. 

"Fever powders 1 ' are death messengers. 

To be a "cheap John" doctor is to be a 
damphule. 

The microbe of laziness is very indus- 
trious. 

Medicate cautiously; don't throw a 
boulder at a gnat. 

Don't be too proud of your he-ness; 
any woman can beat you driving a hen. 

"It is meet that we should eat/' but 
don't get carnivorous on that account. 

Although a cow would udderly refuse 
to "give down" her milk to the calf of 
your leg, you should be kind to kine. 

It is a shameful fact that a louse is not 
too proud to inhabit a tramp. 

The mean between calomel and tartar 
emetic is mean enough. 

" As she slips , she slides." What , then f 
is the use of anything? 

Even the reflections of the tape-worm 
are gutteral. 

Oleum tig makes its own way. 

When the professional abortionist dies 



144 PREVENTIVE MEDICINE 

he will have to climb up to get into hell. 

Surgical gynecology will stand much 
neglect. 

Nature's cruelty is nature's necessity. 

When you get old deny your wrinkles : 
Call them stretched dimples. 

Eliminate all the "ifs" you can — re- 
member what an if did for the proverbial 
dog. 

The hardest thing to do is not to do the 
thing you most want to do. 

The quack who knows himself to be a 
quack, is a beast of prey. 

The spirit of beauty is love. 

If there is a God and God is good, all 
is right. 

A smile is a gleam from the divine of 
man. 

What is more touching than the appeal 
in a wounded animal's eyes? 

The trust of innocence is a direct mes- 
sage from God. 

The man who maltreats a woman or a 
child throws a halo about the ghost of the 
whipping-post. 

The free adviser is always on tap. 



PREVENTIVE MEDICINE J 45 

Almost there are none but women left 
to save to us immortal certainty. 
Whither ; alas ! whither? 

The habitual dog poisoner is a sneak, 
and an assassin. 

The average boy would rather "play fer 
keeps" than go to heaven. The one is 
present and attainable ; the other, distant 
and doubtful. 

What is a, pious boy like, anyhow? 

Many a preacher's ' 'pshaw!" holds as 
much sulphur as the sailor's honest 
"damn!" 

Hysteria is an E-pluribus-in-unum dis- 
ease. 

A hornet is not as big as you are, but 
he'll beat you in an argument. 

Preserve us from the "New Thought" 
writer who makes a specialty of optim- 
ism. 

The skeeter is bigger than an elephant 
in reference to malaria and yellow fever. 

A wasp is in the best humor when it 
is the maddest. 

Scarlet fever is of the same color as any 
other fever. 



146 PREVENTIVE MEDICINE 

A jealous Tom cat can, in one second, 
generate a thousand volts of anger to the 
square inch. 

Where would you locate the primal 
lesion in " idiopathic fever?" 

If we came from nothing and will go 
to nothing, then you shall not have lived, 
for 0-1-0-0. 

People think they "rush the growler ;" 
the fact is the " growler" rushes them. 

Headache powders are harmless, if you 
don't swallow them. 

Medical sectarianism is at once wrong 
and right : more right than wrong, 
though, for the friction it begets explains 
medical progress. 

The busy gonococcus is no respecter of 
persons, whence many (exclusive) social 
surprises. 

Every person is as good, and bad, as 
he or she can be at any moment. 

The man who injures you is sure to 
think hard of you for it. 

The ant-mire and the busy bee 
Set copies good for you and me. 

It is the insidious evil that is hard to 



PREVENTIVE MEDICINE 147 

cure ; we do not have to coax a man to 
let go of red hot iron. 

Coal-tar products— heart-failure— death 
— murder. 

The "thunder of the Vatican" is be- 
coming more distant as the world moves 
on. 

The dawn of sex-consciousness — what a 
moral miracle? 

A dead king isn't worth half as much 
as a live tumble-bug. 

Have you ever realized what a blessing 
it is that elephants are elephants, and 
not locusts? 

A dream within a dream is a dieam 
without a dream. 

Myelin, myosinogen, lecithin and 
fibrinogen are close blood relations. 

"Bleed down to the brandy point, then 
brandy up the bleeding point" — the 
bloody, barbarous philosophy of a murder- 
ous medical past. 

Most booms take on an erang at last. 

Is not serum therapy theory therapy? 

Stuck-hog ethics is good enough for the 
professional sport. 



Cooper s Immortality, 

RECENTLY PUBLISHED, 

Represents the author's ripest thought on the most mo- 
mentous of all questions. That this work is worth 
while has been attested already by some ot 
the prof oundest thinkers of the world* 

Rev. Minot J. Savagb, himself the author of 
a little library of books along this line, said in a 
private letter: "It is remarkably clear and strong; 
I thank you for writing 1 it and publishing it." 

Dr. Rai,cy Hustkd Be 1,1,, a poet, philosopher, 
Hterateur, author and critic, said in a private let- 
ter: **You have done the trick; you have written 
the greatest of all books on the subject." 

Walter Hurt, a poet, philosopher, journalist, 
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masterly handling of a mighty question: is filled 
with large thoughts, expansively expressed. * * * 
Every persou to whom the idea of immortality even 
remotely appeals should read this remarkable book" 

John Uri Li*oyd, eminent scientist and nov- 
elist, said in the Medical Gleanor: "You will find 
Dr. Cooper's Immortality a book so full of thought 
outreaches, so kind in its reasonings, so positive 
and convincing in its earnestness, as to effect yon 
in a way that perhrps no other book has done." 

B. O. Flowbr said hi the Arena: "It repre- 
sents the ripest thoughts and conclusions of a well 
known physician who for many years has been a 
deep student of life in all its aspects." 

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acutely presented, so subtly at times that the ma- 
terialist may not realize his decapitation." 

The foregoing are only a few of the good 
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PRICE $1,00, Postpaid. 

Address, preferably Otherwise 

SCUDDER BROS. CO, DR. V. C COOPER, 

109 Plum St., Cincinnati. Clevea, Ohio, 



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